Partial livers: Good transplant option for infants

Deceased-donor partial liver transplantation now has outcomes in infants and small children that are comparable to those achieved with whole organ transplantation. Increased confidence in this procedure could increase the pediatric organ pool dramatically, thereby decreasing the high waitlist mortality of this age group.

Researchers studied 2,679 first-time, deceased-donor recipients under the age of 2 years receiving a liver alone. Approximately half of the participants received partial livers, while the other half received whole organs. The investigators also looked at 3 time periods to see how the risks associated with the 2 different types of grafts changed over time.

Their results showed that although significant differences existed in survival according to graft type during the period 1995 to 2000, graft survival between the 2 groups was comparable during the periods 2001 to 2005 and 2006 to 2010. And although the adjusted hazards of partial graft failure and mortality were 1.40 and 1.41, respectively, in those procedures performed between 1995 and 2000, the adjusted risks of graft failure and mortality for the partial and whole liver transplant groups for the period 2006 to 2010 were 0.81 and 1.02, respectively. Thus, partial grafts actually had slightly better outcomes than whole organ transplants.

The option is an important one given that so few whole livers of the correct size become available for this population. According to the investigators, infants and young children awaiting liver transplantation have the highest waitlist mortality of all transplant candidates. 

For more information, visit the United Network for Organ Sharing (UNOS) and the Scientific Registry of Transplant Recipients.