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Many young children with liver failure die while waiting for a transplant or soon after receiving one

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A new analysis reveals unacceptable mortality rates in young US children with chronic liver disease while they are on transplant waiting lists as well as after transplantation.

From 2003 to 2013, wait-list mortality among young children under 2 years of age was 12.4 percent and post-transplant mortality was 8 percent, accounting for an overall post-listing mortality of 19.6 percent.

The multivariable analysis of clinical variables revealed that young children with a pediatric end-stage liver disease (PELD) score >21, a lower initial height (10 kg) had a 3-times, 6-times, 2-times higher risk of wait-list mortality, respectively.

"Multiple factors beyond those included in PELD may need to be incorporated in a more comprehensive, multi-variable scoring system to identify higher risk patients earlier, with the potential of improving outcomes in this young and vulnerable group," said Dr. Daniel Leung, lead author of the Liver Transplantation study.

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