ArticleBMC pediatrics2026
National registry on characteristics and outcomes of pediatric liver transplantation in a middle-income country.
Article in BMC pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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14 authors.
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Abstract
backgroundDue to the limited data available among middle-income countries, we aimed to determine the characteristics, outcomes and associated factors with death or graft failure in pediatric liver transplantation (LT).
methodsBased on the Thai National Liver Transplantation Registry, we analyzed the data of patients under 18 years who underwent LT in Thailand from 2016 to 2024.
resultsThe study included 324 liver transplants (five re-LT), mainly from living donors (246 donors, 75.9%). Among 319 recipients, the most prevalent underlying condition was cirrhosis (274 patients, 85.9%; mostly biliary atresia), followed by acute liver failure (30 patients, 9.4%). In comparison with deceased donor LT, patients who underwent living donor LT (LDLT) reported less waiting time (485 days vs. 146 days, P < 0.001) and a lower pediatric end-stage liver disease (PELD)/model for end-stage liver disease (MELD) score (20.9 vs. 18.1, P = 0.02). The registry revealed 1- and 5-year patient survival rates of 91.7% and 89.6%, respectively. Mortality was noted in 34 patients, with infection as the leading cause of death (19 patients, 55.9%). PELD/MELD score ≥ 20 was associated with death (HR: 2.95; 95% CI: 1.29-6.27) or graft failure (HR: 3.10; 95% CI: 1.37-7.06) in patients who underwent LT due to cirrhosis.
conclusionsPediatric LT in Thailand, mainly LDLT, has a satisfactory outcome. Patients with severe ESLD or high PELD/MELD scores are at risk for death and graft failure after LT. Infection is the most common cause of death. Therefore, timely LT and early effective treatment of infection are crucial.
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