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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1182-1190 |
| Number of pages | 9 |
| Journal | American Journal of Transplantation |
| Volume | 22 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 2022 |
Funding
This work was supported in part by Health Resources and Services Administration contract 234‐2005‐370011C and by an NIH‐NIDDK T32 DK007762 (Dr. Cheng). The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government. “Not everything that counts can be counted” is attributed to William Bruce Cameron, Informal Sociology, a causal introduction to sociological thinking, Random House, New York 1963: p. 13. This work was supported in part by Health Resources and Services Administration contract 234-2005-370011C and by an NIH-NIDDK T32 DK007762 (Dr. Cheng). The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government. ?Not everything that counts can be counted? is attributed to William Bruce Cameron, Informal Sociology, a causal introduction to sociological thinking, Random House, New York 1963: p. 13.
Keywords
- Organ Procurement and Transplantation Network (OPTN)
- clinical research/practice
- health services and outcomes research
- liver disease
- liver transplantation/hepatology
- organ transplantation in general
- patient survival
- pediatrics
- registry/registry analysis
- transitional care
ASJC Scopus subject areas
- Transplantation
- Pharmacology (medical)
- Immunology and Allergy