Background and Aims The European Liver Transplant Registry (ELTR) has collected data on liver transplant procedures performed in Europe since 1968. Approach and Results Over a 50-year period (1968-2017), clinical and laboratory data were collected from 133 transplant centers and analyzed retrospectively (16,641 liver transplants in 14,515 children). Data were analyzed according to three successive periods (A, before 2000; B, 2000-2009; and C, since 2010), studying donor and graft characteristics and graft outcome. The use of living donors steadily increased from A to C (A, n = 296 [7%]; B, n = 1131 [23%]; and C, n = 1985 [39%]; p = 0.0001). Overall, the 5-year graft survival rate has improved from 65% in group A to 75% in group B (p < 0.0001) and to 79% in group C (B versus C, p < 0.0001). Graft half-life was 31 years, overall; it was 41 years for children who survived the first year after transplant. The late annual graft loss rate in teenagers is higher than that in children aged Pediatric liver transplantation has reached a high efficacy as a cure or treatment for severe liver disease in infants and children. Grafts that survived the first year had a half-life similar to standard human half-life. Transplantation before or after puberty may be the pivot-point for lower long-term outcome in children. Further studies are necessary to revisit some old concepts regarding transplant benefit (survival time) for small children, the role of recipient pathophysiology versus graft aging, and risk at transition to adult age.
C1 [de Goyet, Jean de Ville; di Francesco, Fabrizio] Ist Ricovero & Cura Carattere Sci, Dept Treatment & Study Pediat Abdominal Dis & Abd, Palermo, Italy.
[Baumann, Ulrich] Univ Birmingham, Inst Immunol & Immunotherapy, Birmingham, W Midlands, England.
[Baumann, Ulrich] Hannover Med Sch, Paediat Gastroenterol & Hepatol, Hannover, Germany.
[Baumann, Ulrich; Adam, Rene; Polak, Wojciech G.; Verkade, Henkjan J.] European Liver & Intestine Transplant Assoc, Padua, Italy.
[Karam, Vincent; Adam, Rene; Liver, European] Univ Paris Sud, Hop Paul Brousse, AP HP, European Liver Transplant Registry,Inserm U 935, Villejuif, France.
[Nadalin, Silvio] Univ Hosp Tubingen, Dept Gen Visceral & Transplant Surg, Tubingen, Germany.
[Heaton, Nigel] Kings Coll Hosp London, London, England.
[Reding, Raymond] Catholic Univ Louvain, Clin Univ St Luc, Brussels, Belgium.
[Branchereau, Sophie] Bicetre Univ Hosp, AP HP, Serv Chirurg Viscerale Pediat, Fac Med Paris Sud, Le Kremlin Bicetre, France.
[Mirza, Darius] Univ Hosp Birmingham NHS Fdn Trust, Queen Elizabeth Hosp Birmingham, Liver Unit, Birmingham, W Midlands, England.
[Klempnauer, Juergen L.] Hannover Med Sch, Klin Viszeral & Transplantat Chirurg, Hannover, Germany.
[Fischer, Lutz] Univ Med Ctr Hamburg Eppendorf, Dept Visceral Transplantat, Hamburg, Germany.
[Kalicinski, Piotr] Childrens Mem Hlth Inst, Dept Pediat & Transplant Surg, Warsaw, Poland.
[Colledan, Michele] Univ Milano Bicocca, Dept Organ Failure & Transplantat, ASST Giovanni XXIII, Bergamo, Italy.
[Lopez Santamaria, Manuel] Hosp Infantil Univ La Paz, Pediat Surg Dept, Madrid, Spain.
[de Kleine, Ruben H.] Univ Groningen, Univ Med Ctr Groningen, Dept Surg, Sect HepatoPancreat Biliary Surg, Groningen, Netherlands.
[Chardot, Christophe] Hop Necker Enfants Malad, Serv Chirurg Pediat, Paris, France.
[Yilmaz, Sezai] Inonu Univ, Liver Transplantat Inst, Malatya, Turkey.
[Kilic, Murat] Izmir Kent Hosp, Liver Transplant Program, Izmir, Turkey.
[Boillot, Olivier] Hop Edouard Herriot, Pediat Liver Transplant Surg, Lyon, France.
[Polak, Wojciech G.] Univ Med Ctr Rotterdam, Transplant Inst, Dept Surg, Div Hepatopancreatobiliary & Transplant Surg,Eras, Rotterdam, Netherlands.
[Verkade, Henkjan J.] Univ Groningen, Univ Med Ctr Groningen, Dept Pediat, Groningen, Netherlands.