Currently, graft options for pediatric liver transplantation (PLT) include whole (WL) and partial (P) grafts, in the form of either deceased donor transplantation (DD) or living donor liver transplantation (LD). WL transplants from LD are commonly referred to as domino LT. The objective of this manuscript is to compare the outcomes of PLT performed with each of the available graft options. Retrospective cohort study from Jan. 2010 to Dec. 2022. The variables included data on the recipients’ preoperative clinical status, intraoperative technical aspects, post-operative complications, and survival studies. There were 4 groups: SPLIT (17), DD-WL (55), LD-WL (824), and LD-P (22). The median age and BW of the recipients was smaller in SPLIT, LD-P, and LD-WL compared to DDT-WL groups. HVOO (HR 15.87, 95% CI 1.89-133.06, P = 0.01), retransplantation (HR 7.94, 95% CI 2.63-24.02, P < 0.01), and malignancies (HR 3.08, 95% CI 1.29-7.37, P = 0.01) were independently associated with decreased patient survival. HAT (HR 27.54, 95% CI 10.44-72.68, P < 0.01) and malignancies (HR 2.42, 95% CI 1.10-5.34, P = 0.03) increased the risk of graft loss. The overall survival in this series was 91.4% (mean follow-up of 74.3 months). Patient and graft survival were not different among groups. HAT and malignancies were associated with reduced graft survival. Whole liver from living donors with MSUD presented 100% patient survival at 120 months. Even without statistical differences in survival among the studied groups, LD-P and LD-WL recipients presented a trend towards better outcomes. LEVEL III.

中文翻译：

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活体捐献者整个和部分肝移植、死者捐献者整个肝脏和分割：结果比较

目前，儿科肝移植 (PLT) 的移植物选择包括整体 (WL) 和部分 (P) 移植物，形式为死亡供体肝移植 (DD) 或活体供体肝移植 (LD)。从 LD 移植的 WL 通常称为多米诺骨牌 LT。本手稿的目的是比较 PLT 与每种可用移植方案的结果。2010年1月至2022年12月的回顾性队列研究。变量包括受者术前临床状态、术中技术问题、术后并发症和生存研究的数据。共有 4 组：SPLIT (17)、DD-WL (55)、LD-WL (824) 和 LD-P (22)。与 DDT-WL 组相比，SPLIT、LD-P 和 LD-WL 组中接受者的中位年龄和体重较小。HVOO（HR 15.87，95% CI 1.89-133.06，P = 0.01）、再移植（HR 7.94，95% CI 2.63-24.02，P < 0.01）和恶性肿瘤（HR 3.08，95% CI 1.29-7.37，P = 0.01） ）与患者生存率下降独立相关。HAT（HR 27.54，95% CI 10.44-72.68，P < 0.01）和恶性肿瘤（HR 2.42，95% CI 1.10-5.34，P = 0.03）增加移植物丢失的风险。该系列的总生存率为 91.4%（平均随访时间为 74.3 个月）。患者和移植物的存活率在各组之间没有差异。HAT 和恶性肿瘤与移植物存活率降低有关。患有 MSUD 的活体捐献者的整个肝脏在 120 个月时患者存活率为 100%。即使研究组之间的生存率没有统计差异，LD-P 和 LD-WL 接受者也呈现出更好结果的趋势。第三级。