Faculty Collaboration Database

The reduced left lateral segment in pediatric liver transplantation: an alternative to the monosegment graft. Pediatr Transplant 2008 Sep;12(6):696-700

Date

09/13/2008

Pubmed ID

18786070

DOI

10.1111/j.1399-3046.2007.00882.x

Scopus ID

2-s2.0-49349114753 (requires institutional sign-in at Scopus site)   23 Citations

Abstract

Tailoring graft size to small paediatric recipients is a challenge. We have developed a reduced left lateral segment as an alternative to monosegment transplantation for small size recipients. Since November 2000, 89 children have been transplanted with 100 deceased donor liver grafts in our unit. Our median patient and graft survival is 89% and 88% respectively. Four of these cases were performed using a new technique of creating a small donor graft by reducing the left lateral segment. The median weight of the reduced liver graft was 264 g (range: 165-390 g). The median blood transfusion requirement was 101 mL/kg body weight (range 69-167 mL/kg). The median values of peak ALT were 1473 IU/L, INR 2.2 and bilirubin 293 micromol/L in the first two wk following surgery. One neonatal recipient died five days after transplantation from a massive intracranial haemorrhage despite satisfactory graft function. Another recipient with excellent graft function died 10 months later from primary pulmonary hypertension and secondary cardiac failure. Hepatic artery thrombosis occurred in one patient with successful revascularization but he was retransplanted three months later for chronic rejection. No biliary or venous outflow complications occurred in this group. This technique of reduced left lateral segment liver transplantation is an alternative to the monosegment graft and allows small recipients to be successfully transplanted with few technical complications related to graft preparation.

Author List

Attia MS, Stringer MD, McClean P, Prasad KR

Author

Kondragunta Rajendra Prasad MBBS Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Blood Transfusion
Female
Graft Survival
Hepatic Artery
Humans
Infant
Infant, Newborn
Liver
Liver Function Tests
Liver Transplantation
Male
Organ Size
Pediatrics
Thrombosis
Treatment Outcome