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The Society of Pediatric Liver Transplantation (SPLIT): 2023 Registry Status

06/2025

Journal Article

Authors:
Banc-Husu, A. M.; Smith, R.; Kelly, B.; Anand, R.; Anderson, S. G.; Lobritto, S.; Chapin, C. A.; Chartier, M. E.; Ekong, U. D.; Elisofon, S. A.; Feldman, A.; Furuya, K. N.; Garcia, J.; Gonzalez-Peralta, R.; Gutierrez Sanchez, L. H.; Hildreth, A.; Himes, R.; Ibrahim, S. H.; Jain, A.; Kerkar, N.; Leung, D. H.; Mazareigos, G.; Ng, V. L.; Pai, A.; Pan, D. H.; Peters, A. L.; Shakhin, V.; Stoll, J.; Wadera, S.; Hsu, E.; Squires, J. E.; Valentino, P. L.; Society of Pediatric Liver, Transplantation

Volume:
29

Issue:
5

Journal:
Pediatr Transplant

PMID:
40522021

URL:
https://www.ncbi.nlm.nih.gov/pubmed/40522021

DOI:
10.1111/petr.70111

Keywords:
Humans *Liver Transplantation/mortality *Registries Infant Female Male Child Child, Preschool Adolescent Treatment Outcome Societies, Medical Infant, Newborn Retrospective Studies children liver transplantation outcomes

Abstract:
BACKGROUND: The Society of Pediatric Liver Transplantation (SPLIT) has undergone tremendous growth with > 45 sites contributing data focusing on improving outcomes in pediatric liver transplantation (LT). We report and compare outcomes from the SPLIT Registry. METHODS: Patients < 18 years with first-time LT only enrolled into the SPLIT Registry between 2011 and 2023 were included. Data was stratified into eras from the last published registry update (era 1: 2011-2018, era 2: 2018-2023). RESULTS: Three thousand five hundred four participants from 47 centers were included (era 1: n = 2159; era 2: n = 1345). Age distribution differed with more children < 1 year. of age at LT in era 2 (era 1: 29% vs. era 2: 33%, p = 0.01). Indications for LT were similar, with biliary atresia (38.8%) and metabolic disease (16.0%) being most common. Exception point use was higher in era 2 (era 1: 45% vs. era 2: 56%, p < 0.001). No difference in graft type (deceased: 81% era 1 vs. 78% era 2, p = 0.78), patient survival at 90 days (era 1: 98.7% vs. era 2: 98.3%), 1 year (era 1: 97.2 vs. era 2: 96.8%), or 3 years (era 1: 95.3% vs. era 2: 95.2%) was noted. Rate of hepatic artery thrombosis was lower in era 2 (era 1: 7% vs. era 2: 5%, p = 0.02). CONCLUSIONS: Trends in pediatric LT within SPLIT note similar LT indications and graft type, higher utilization of exception points, and lower HAT rates despite transplanting more children < 10 kg. This data underscores the evolution of pediatric LT toward higher survivability and overall patient outcomes.

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