Pediatric liver transplantation for autoimmune liver disease: Ten-year experience from a liver transplant center in India

Spectrum of Pediatric Autoimmune Hepatitis in a Cohort of Pakistani Children

Background. Autoimmune hepatitis (AIH) is increasingly seen in children worldwide and it is more severe in children compared to adults. This study highlights the biochemical and clinical aspect, treatment given and outcome of the disease including pediatric liver transplantation. Study. Retrospective review (2012-2022) was done in Shifa International Hospital, Islamabad. Patients under 18 years diagnosed with AIH were included. Data related to age, gender, clinical features, laboratory investigations including liver function test, liver biopsy findings and imaging modalities were included. Results. Fifteen patients were included 7 (47%) were males and 8 (53%) females. AIH type 1 was the most common type seen in 7 (46%), AIH type 2 in 5 (33%) and seronegative in 3 (20%). Jaundice was the most common symptom. Liver biopsy showed findings characteristic of AIH. Liver transplant performed in 3 patients. Conclusion. The study highlights the varied clinical presentation of AIH in Pakistani children.

Liver Transplantation Research from India During the Last 25 Years: 1998-2022

Background and aims

Liver transplant surgery has been performed in India for the last 25 years. We aimed to analyse the trends, characteristics, and key elements in the field of liver transplantation research from India.

Methods

On April 23, 2023, we conducted a search of the Scopus database for the literature on liver transplantation research, using a well-defined search strategy. MS Excel and VOS viewer software programs were used to examine the articles for organisation, author, journal, keywords, and high-cited literature.

Results

This analysis examined a total of 556 papers, which constituted only a 1.55% share of the global output. These papers involved 442 organizations, 1575 authors, and 147 journals. External funding was received in 4.13% and 23.56% were involved in international collaboration. Three Delhi-NCR organizations, namely the Medanta-The Medicity (n = 63), Institute of Liver & Biliary Sciences (n = 60), and Indraprastha Apollo Hospital (n = 48) led in publication productivity. M. Rela (n = 90) and A.S. Soin (n = 63) were the leading authors in publication productivity, while S. Sudhindran and P. Bhangui were the most impactful authors. Liver Transplantation (n = 96) and Journal of Clinical & Experimental Hepatology (n = 65) published the maximum number of these papers, whereas, Annals of Surgery and Journal of Hepatology led in the citation impact per paper. The most significant keywords were "Liver Transplantation" (n = 484), and "Living Donor" (n = 254). Only 1.80% (n = 10) of the papers were highly cited papers that received 50 to 142 citations and they together registered 69.9 citations per paper.

Conclusion

Although the number of publications on liver transplantation from India started growing recently, it forms only 1.55% of the global report. There is an unmet need to increase government-supported research and multicenter collaborative studies at national and international levels for high-quality patient care.