Not everything that counts can be counted: Tracking long‐term outcomes in pediatric liver transplant recipients. Issue 4 (8th January 2022)

• Record Type: Journal Article
• Authors: Cheng, Katherine; Feng, Sandy; Bucuvalas, John C.; Levitsky, Josh; Perito, Emily R.
• Is Part Of: American journal of transplantation. Volume 22:Issue 4(2022)
• Page Start: 1182
• Page End: 1190
• Publication Date: 2022-01-08
• Subjects: clinical research/practice -- health services and outcomes research -- liver disease -- liver transplantation/hepatology -- Organ Procurement and Transplantation Network (OPTN) -- organ transplantation in general -- patient survival -- pediatrics -- registry/registry analysis -- transitional care; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.16932
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : For pediatric liver transplant (LT) recipients, an ideal outcome is to survive and thrive into adulthood. However, outcomes reporting for all LT recipients typically rely on much shorter‐term outcomes, 1–5 years post‐LT. Using Organ Procurement and Transplantation Network (OPTN) registry data from 1990 to 2018, this analysis seeks to determine if long‐term follow‐up and outcome data are complete for pediatric LT recipients age 0 to 12 years who survive at least 1 year post‐LT without graft loss ( n = 9309). Of the 7948 pediatric transplant recipients who did not die or require re‐LT, 1 in 6 was reported as lost to follow‐up by their transplant center during long‐term follow‐up. Rates of lost to follow‐up were highest in those transplanted between 1990 and 1999 and increased in early adulthood for all recipients. Almost 10% of pediatric LT recipients who remained in follow‐up required relisting for LT. 8% of children remaining in follow‐up had graft failure. Lost to follow‐up may bias estimates of long‐term outcomes and risk factors for poor outcomes. For those remaining in follow‐up, graft failure and death continue to occur in the decades after LT. Continued proactive monitoring, management, and innovations are needed to truly optimize post‐LT survival for all children. Abstract : Analysis of long‐term outcomes for pediatric liver transplant recipients highlights not only insights from and but also gaps in available data.