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Research Snapshot Theater: Transplant Medicine, Adult and Pediatric

One-Year Survival & Acute Rejection in Pediatric Liver Transplantation: 15-Year Retrospective Study

Tuesday, March 24, 2026
11:15 AM - 12:15 PM Central Time
Location: Connections Central - RST 14
Introduction: Liver transplantation (LT) is the only effective treatment for end-stage liver disease in children. In high-resource countries, survival after liver transplantation in pediatric patients has been greatly improved; however, data are limited at the local level, especially from Indonesia. The study aims to analyze one-year survival and acute rejection in pediatric liver transplant recipients in Cipto Mangunkusumo Hospital, Jakarta, concerning the related risk factors.


Methods: A retrospective cohort analysis of 78 children ( < 18 years) who underwent liver transplantation between 2010 and 2025 was performed by reviewing their medical records. The incidence of acute rejection, survival rates, the main clinical factors related to this complication and surgical and post-surgical risk factors will be calculated using bivariate and multivariate analyses in all patients included


Results: A one-year survival rate of 82.1% was reported, with 14 patients (17.9%) having died within the year after transplant. Acute rejection occurred in 22 patients (28.2 %). Results of multivariate analysis are that prolonged operative duration (>12 hours) was significantly associated with mortality (p = 0.033; OR 4.452; 95% CI:1.130–17.541), and vascular complication played a role as an independent predictor of AR cases (p = 0.019; OR 5.687; 95% CI:1.330–24.310). Other factors, including PELD score, intraoperative blood loss, warm ischemic time, and electrolyte disturbances, were not independently associated with adverse outcomes.


Conclusions: The one-year survival rate of pediatric liver transplantation at Cipto Mangunkusumo Hospital is good. Long operative time is an independent risk factor for mortality, and vascular complications are significant predictors of early rejection. These results highlight the importance of focused surgical protocols and careful postoperative surveillance for better transplant outcomes in low-resource regions.