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Abstrak :
Latar belakang. Transplantasi hati merupakan terapi definitif untuk penyakit hati tahap akhir baik pada dewasa maupun anak. Beberapa dekade terakhir, kemajuan dalam teknik bedah, perservasi, terapi imunosupresif, pemantauan dan pengobatan infeksi telah meningkatkan keberhasilan transplantasi hati. Penelitian ini bertujuan untuk mengidentifikasi faktor-faktor yang memengaruhi kesintasan satu tahun pasien dan graft pasca-transplantasi di Rumah Sakit Cipto Mangunkusumo. Metode. Penelitian ini merupakan studi kohort retrospektif yang mengkarakterisasi pasien <18 tahun yang menjalani transplantasi hati selama periode tahun 2010 dan 2022. Sumber data melalui penelusuran rekam medis. Kurva Kaplan-Meier digunakan untuk menggambarkan kesintasan pasien dan graft. Analisis statistik bivariat dan multivariat dilakukan dengan menggunakan uji log-rank dan Cox’s proportional hazards. Nilai p <0,05 dianggap signifikan pada analisis multivariat. Hasil. Sebanyak 55 pasien anak yang menjalani transplantasi hati; 50,9% adalah lelaki dengan rerata usia 16 bulan. Atresia bilier merupakan penyebab terbanyak dari penyakit hati kronis tahap akhir yang menjalani transplantasi hati. Kesintasan satu tahun secara keseluruhan adalah 85,5%. Berdasarkan hasil analisis multivariat, skor pediatric end-stage liver disease (PELD) ≥20 (p = 0,011) dan durasi operasi ≥16 jam (p = 0,002) merupakan faktor yang berhubungan dengan kesintasan pasien dan graft yang lebih rendah. Kesimpulan. Pemantauan khusus direkomendasikan pada pasien anak dengan skor PELD tinggi yang menjalani transplantasi hati dan durasi operasi yang lebih lama untuk meningkatkan kesintasan pasien dan graft. Diperlukan penelitian lebih lanjut dengan ukuran sampel yang lebih besar untuk mendapatkan hasil yang signifikan terhadap kesintasan pasien dan graft. ......Background. Liver transplantation is the treatment of choice for end-stage liver in both adults and children. The last few decades, progress in terms of surgical techniques, preservation, immunosuppressive therapy, monitoring and treatment of infection have improved survival of liver transplantation. This study aims to identify factors that influence one-year post-transplant patient and graft survival at Cipto Mangunkusumo General Hospital. Methods. This is a retrospective cohort analysis characterizing patients transplanted between 2010 and 2022 included all recipients <18 years of age undergoing pediatric liver transplantation. Data sources included hospital medical records. Outcomes measures were overall patient and graft survival. Kaplan-Meier Curve is used to describe patient and graft survival. Bivariate and multivariate statistical analysis was undertaken using log-rank test and Cox’s proportional hazards model. A p value <0.05 was considered significant at the multivariate level. Results. A total of 55 pediatric patients underwent liver transplantation; 50,9% were boys and median age was 16 months. Biliary atresia were the most common causes of liver disease. Overall 1-year survival rates were 85.5%. According to multivariate analysis, pediatric end-stage liver disease (PELD) score ≥20 (p = 0.011) and operative duration ≥16 hours (p = 0,002) were factors associated with worse patient and graft survival. Conclusion. Greater caution is recommended in pediatric patients with high PELD score undergoing liver transplantation and longer operative duration to improve patient and graft survival. Further research is needed with larger sample size to obtain a significant impact on patient and graft survival.

Abstrak :
ABSTRACT
BACKGROUND:kidney transplantation has been developing rapidly in Indonesia in recent years, yet data on transplants' characteristics and survival is still unavailable. In Indonesia, only living donors are permitted. Living donor are advantageous, but challenging to recruit. This study aimed to establish the graft and patient survival rates and to describe the characteristics of recipient and donor as well as the process of donor recruitment and evaluation of kidney transplantation in Indonesia.METHODS:the study was a retrospective cohort on all donors and kidney transplant recipients at Cipto Mangunkusumo General Hospital (CMGH) from January 2011 to May 2017. Only recipients from January 2011 to May 2014 were included to establish the 1-year and 3-year graft and patient survival; which were described using Kaplan-Meier method. RESULTS:data from 492 kidney transplant procedures were obtained (donor median age, 30 (17 - 66) years; 25.1% were family-related. Recipients mean age, 47 (SD 13.18 years). Data from total of 138 kidney transplant recipients were further analyzed. The 1-year death- censored graft survival, all-cause graft survival and patient survival were 92 %, 82.6 % and 87%. The 3-year death-censored graft survival, all-cause graft survival and patient survival were 90.6%, 76.1% and 79.7%. Kaplan-Meier's curve showed the highest mortality rates occured in the early months.CONCLUSION:the 1-year graft and patient survival rate were 92% and 87%. The 3-year graft and patient survival rate were 90.6% and 79.7%. Only small percentage of donor were family-related. Living donor recruitment and evaluation are still a big challenge in Indonesia