Farmer et al identified preoperative risk factors associated with graft and patient survival following pediatric liver transplant. These can help match patients and available organs. The authors are from UCLA.


Predictors of worse graft survival:

(1) decreased renal function (calculated creatinine clearance < 90 mL/min per 1.73 m sq)

(2) prolonged warm ischemia time (> 60 minutes)


Predictors of worse patient survival:

(1) decreased renal function

(2) pretransplant dependency on mechanical ventilation

(3) type of underlying liver disease


Types of liver disease associated with poor patient survival:

(1) retransplantation

(2) autoimmune liver disease

(3) parenteral nutrition associated liver disease

(4) tumor

(5) neonatal hepatitis



• Creatinine clearance was estimated using the equations of Schwartz et al (see Chapter 14, 14.02.07). The estimates are in mg/dL per 1.73 square meters BSA.

• Cholestatic liver disease was used as the reference disease for comparing survival with other liver diseases.



• The graft survival at 10 years with no graft-related risk factors was 80% (about 10% show early graft loss).

• The graft survival at 10 years with 1 or 2 graft-related risk factors was about 60%.(about 25% show early graft loss).

• The 10 year survival for a patient with no risk factors is about 95%.

• The 10 year survival for a patient with 1 or 2 risk factors is about 75%.

• The 10 year survival for a patient with 3 risk factors is 50%. Most of the mortality occurs within the first 3 months after the transplant.


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