National registry on characteristics and outcomes of pediatric liver transplantation in a middle-income country

Background Due to the limited data available among middle-income countries, we aimed to determine the characteristics, outcomes and associated factors with death or graft failure in pediatric liver transplantation (LT).Methods Based on the Thai National Liver Transplantation Registry, we analyzed the data of patients under 18 years who underwent LT in Thailand from 2016 to 2024.Results The study included 324 liver transplants (five re-LT), mainly from living donors (246 donors, 75.9%). Among 319 recipients, the most prevalent underlying condition was cirrhosis (274 patients, 85.9%; mostly biliary atresia), followed by acute liver failure (30 patients, 9.4%). In comparison with deceased donor LT, patients who underwent living donor LT (LDLT) reported less waiting time (485 days vs. 146 days, P Conclusions Pediatric LT in Thailand, mainly LDLT, has a satisfactory outcome. Patients with severe ESLD or high PELD/MELD scores are at risk for death and graft failure after LT. Infection is the most common cause of death. Therefore, timely LT and early effective treatment of infection are crucial.