Quality of life in long-term survivors of pediatric living related-donor liver transplantation

In this study, we discuss the quality of life with reference to the growth of long-term survivors to evaluate the prognosis of liver transplantation. Nine of 41 pediatric patients who received living related-donor liver transplantation (LRLT) in our institution from 1991 to the present are now in alive more than 6 years after surgery. Their quality of life, physical development, liver function, and need for immunosuppressive therapy were analyzed. Physical growth is improved by LRLT, although it still does not to reach the mean level in Japan. Three of the nine patients were successfully withdrawn from immunosuppressive drugs, although one required readministration. Two patients exhibited side effects of steroid administration: one experienced renal lithiasis, and another developed cataracts. One patient needed surgery for ileus, and three had varicella infections. One of 2 patients who received an ABO-incompatible graft continues to show unstable liver function after 9 years. In summary, LRLT is effective in improving the physical growth and the quality of life of patients, but problems remain in their daily lives. In particular, we need to adapt the timing of surgery to take account of physical growth and to discuss the timing of vaccinations to prevent viral infection.