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Pediatric Surgery International
Published in: Pediatric Surgery International 5/2016

01-05-2016 | Original Article

Pediatric liver transplantation: predictors of survival and resource utilization

Authors: Amy E. Wagenaar, Jun Tashiro, Juan E. Sola, Obi Ekwenna, Akin Tekin, Eduardo A. Perez

Published in: Pediatric Surgery International | Issue 5/2016

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Abstract

Purpose

We sought to identify factors associated with increased resource utilization and in-hospital mortality for pediatric liver transplantation (LT).

Methods

Kids’ Inpatient Database (1997–2009) was used to identify cases of LT in patients <20 years old.

Results

Overall, 2905 cases were identified, with an in-hospital survival of 91 %. LT was performed most frequently in < 5 year olds (61 %), females (51 %), and Caucasians (56 %). LT was performed at urban teaching hospitals (97 %) and facilities with children’s units (51 %). Indications included pathologic conditions of the biliary tract (44 %) and inborn errors of metabolism (34 %), though unspecified end stage liver disease was the most common (75 %). Logistic regression found higher mortality in children undergoing LT for malignant conditions (odds ratio: 4.8) and acute hepatic failure (OR 3.4). Cases complicated by renal failure (OR 7.7) and complications of LT (OR 2.7) had higher mortality rates. Resource utilization increased for children with renal failure and those with hemorrhage as a complication of LT, p < 0.05.

Conclusion

Hospital survival is predicted by indication and complications associated with LT. Resource utilization increased with renal failure and complications related to LT. Admission length was sensitive to payer status, hospital characteristics, and UNOS region, whereas total costs were unaffected by payer status or hospital type.
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Metadata
Title
Pediatric liver transplantation: predictors of survival and resource utilization
Authors
Amy E. Wagenaar
Jun Tashiro
Juan E. Sola
Obi Ekwenna
Akin Tekin
Eduardo A. Perez
Publication date
01-05-2016
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Surgery International / Issue 5/2016
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-016-3881-6

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