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Challenges faced in establishing a pediatric liver transplant program in a lower‐middle‐income country with free healthcare service

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dc.contributor.author Fernando, M.
dc.contributor.author Tillakaratne, S.
dc.contributor.author Gunetilleke, B.
dc.contributor.author Liyanage, C.
dc.contributor.author Appuhamy, C.
dc.contributor.author Weerasuriya, A.
dc.contributor.author Uragoda, B.
dc.contributor.author Welikala, N.
dc.contributor.author Ranaweera, L.
dc.contributor.author Ganewatte, E.
dc.contributor.author Dissanayake, J.
dc.contributor.author Mudalige, A.
dc.contributor.author Siriwardana, R.
dc.date.accessioned 2024-02-06T05:01:22Z
dc.date.available 2024-02-06T05:01:22Z
dc.date.issued 2024
dc.identifier.citation Pediatric Transplantation.2024;28(1):e14681 en_US
dc.identifier.uri http://repository.kln.ac.lk/handle/123456789/27536
dc.description Not Indexed en_US
dc.description.abstract ABSTRACT: BACKGROUND: Liver transplant is the cure for children with liver failure. Sri Lanka is a lower-middle-income country with a predominant free, state health system. Pediatric liver transplant program in Sri Lanka is still in the budding state where the initial experience of the program is yet to be documented. METHODS: A retrospective review was performed including the clinical characteristics of all pediatric liver transplant recipients of Colombo North Centre for Liver Diseases since the inception of the program from June 2020 to May 2023. RESULTS: There were 14 PLT performed in 3 years. The median recipient age and weight were 8 years (6 months–15 years) and 23.3 kg (6.4–49.2), respectively. The majority were boys (64%). All were from low-income backgrounds. Indications for LT were acute liver failure (5/14), decompensated chronic liver disease (5/14), and acute on chronic liver failure (4/14). Underlying liver diseases were Wilson disease (6/14), autoimmune liver disease (3/14), biliary atresia (2/14) and progressive familial intrahepatic cholestasis type 3 (1/14), and unknown etiology (2/14). The majority were living donor liver transplants (86%). Of the living donors, 42% (5/12) were Buddhist priests. There were three immediate deaths and two late deaths. The 3-month survival was 78%, and overall survival was 64%. Living donor transplants carried a higher success rate (92%) compared to diseased donor transplants (0%; 2/2). CONCLUSIONS: Initial experience of pediatric liver transplant program of Sri Lanka is promising despite being established in a free healthcare system amidst the crisis circumstances. en_US
dc.language.iso en en_US
dc.publisher Wiley en_US
dc.subject children en_US
dc.subject initial experience en_US
dc.subject liver failure en_US
dc.subject liver transplant en_US
dc.subject Sri Lanka en_US
dc.title Challenges faced in establishing a pediatric liver transplant program in a lower‐middle‐income country with free healthcare service en_US
dc.type Article en_US


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