Abstract

Objective: Pediatric liver transplantation (LT) is the definitive life-saving treatment for children with end-stage liver disease or irreversible liver failure. This study reports the initial outcomes of the pediatric liver transplantation program established at University Medical Center (UMC) Ho Chi Minh City.

Methods: We conducted a retrospective cohort study of pediatric patients (< 16 years old) who underwent LT between November 2021 and March 2026 at University Medical Center, Ho Chi Minh City, with follow-up until 7 April 2026. Data on recipient and donor characteristics, operative variables, postoperative complications, and survival rates were collected and analyzed.

Results: Forty-four cases were included with a median follow-up of 16.89 months (IQR: 10.28 - 30.22; range: 0.56 - 52.69). The median age was 2 years and median weight was 10 kg; biliary atresia was the primary indication (81.8%). Living donor liver transplantation (LDLT) accounted for 88.6% of cases, with 66.7% of donor hepatectomies performed laparoscopically. The median graft-to-recipient weight ratio (GRWR) was 2.28%. Median operative time was 590 minutes, and blood loss was 655 mL. Common complications included pleural effusion requiring drainage (22.7%), acute rejection (18.2%), and CMV infection (9.1%). Cumulative 1-year and 3-year survival rates were 90.5% (95% CI: 76.7 - 96.3%).

Conclusion: Early implementation of pediatric LT at our center is feasible and demonstrates encouraging survival outcomes. While surgical complications remain low, optimizing perioperative care for respiratory and infectious challenges is essential.