[Follow-up of pediatric patients evaluated for liver transplantation].

1997 
Objetivo: Analisar a evolucao de pacientes pediatricos avaliados para Transplante Hepatico. Metodos: Foram revisados os prontuarios das primeiras 65 criancas e adolescentes portadores de hepatopatias cronicas, com idades de 5 meses a 19 anos (x= 6,8 anos), que foram avaliados, de agosto de 1994 a marco de 1996, para realizar transplante de figado. Os dados colhidos foram referentes as caracteristicas demograficas dos pacientes, causa da hepatopatia, avaliacao psicossocial dos pacientes e de seus responsaveis e avaliacao clinico-laboratorial. De acordo com a gravidade da doenca, os pacientes foram classificados como ativos (aguardando doacao), em avaliacao, inativos (hepatopatia compensada) e excluidos por motivos psicossociais, medicos ou por ma indicacao. Resultados: Oito pacientes (12%) foram transplantados, sendo que somente um foi ao obito. Sete (11%) morreram enquanto estavam sendo avaliados ou aguardando um orgao. Dez pacientes (15%) foram excluidos da lista de espera: 6 por problemas sociais e 4 por problemas medicos. Nenhum paciente foi afastado por indicacao incorreta. Seis pacientes estao em lista ativa, aguardando doador. Dos outros pacientes, 23 (35%) estao em avaliacao e 11 (17%) estao como inativos na lista. Conclusoes: Onze pacientes (17%) nao foram submetidos a transplante devido ao avancado grau da hepatopatia. Enfatizamos a importância da doacao de orgaos e o encaminhamento precoce dos pacientes. J. pediatr. (Rio J.). 1997; 73(2): 75-79: transplante hepatico pediatrico, hepatopatia cronica em crianca. Abstract Objective: To analyze the evolution of pediatric patients chosen for hepatic transplantation. Methods: A review was made of the clinical charts of the first 65 children and adolescents with chronic liver disease, aged 5 months to 19 years (X = 6.8%), chosen for liver transplantation during the period of August 1994 to March 1996. Data refer to the patients’ demographic characteristics, etiology of their liver disease, their psychosocial situation and of their parents, and their clinical and laboratorial evaluation. According to the severity of the disease, patients were classified as active (waiting for a donor), in evaluation, inactive (compensated liver disease), and excluded for psychosocial or medical conditions, or because of bad indication. Results: Eight patients (12%) received transplantation, and one of them died. Seven (11%) died when in evaluation or waiting for a donor. Ten patients (15%) were excluded from the waiting list: 6 for social problems, and 4 for medical problems. No patient was excluded for bad indication. Six patients are in the active list, waiting for donor. The other 23 patients (35%) are in evaluation, and 11 (17%) are classified as inactive in the waiting list. Conclusions: Eleven patients (17%) were not operated on due to the advanced stage of the liver disease. We emphasize the necessity of organ donation, and the early contact of the patients with a reference center.
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