BACKGROUND: To alleviate the shortage of size-matched whole-donor organs, too-large-for-size cadaveric donor grafts are modified by liver resection techniques. These modifications result in technical-variant liver transplantation (TVLTx). Patient and graft survival rates after TVLTx are considered comparable to those after full-size liver transplantation (FSLTx). However, morbidity after TVLTx is often underexposed. The aim of this study was to analyze the results of FSLTx and TVLTx in terms of patient and graft survival rates and morbidity. METHODS: A consecutive series of 97 primary and elective pediatric liver transplantations performed in a single center was retrospectively analyzed. Forty-seven children had a FSLTx and 50 a TVLTx (38 reduced-size liver grafts and 12 split-liver grafts). The overall median follow-up period was 3.5 years. RESULTS: There were no differences in patient and graft survival rates between FSLTx and TVLTx. However, after TVLTx there was a significantly higher complication rate (1.42 vs. 0.81 after FSLTx). TVLTx is more hampered by biliary complications (30% vs. 17%), expressed by a higher incidence of cholangitis and leakage of bile. These complications led to a significantly higher incidence of sepsis (44% vs. 19%) and a significantly higher intervention rate (0.40 vs. 1.28) after TVLTx. There was no difference in the incidence of retransplantations between FSLTx and TVLTx. CONCLUSIONS: Both FSLTx and TVLTx offer the same prognosis in terms of patient and graft survival rates for children after a primary and elective liver transplantation. However, TVLTx has a higher morbidity.
BACKGROUND: To alleviate the shortage of size-matched whole-donor organs, too-large-for-size cadaveric donor grafts are modified by liver resection techniques. These modifications result in technical-variant liver transplantation (TVLTx). Patient and graft survival rates after TVLTx are considered comparable to those after full-size liver transplantation (FSLTx). However, morbidity after TVLTx is often underexposed. The aim of this study was to analyze the results of FSLTx and TVLTx in terms of patient and graft survival rates and morbidity. METHODS: A consecutive series of 97 primary and elective pediatric liver transplantations performed in a single center was retrospectively analyzed. Forty-seven children had a FSLTx and 50 a TVLTx (38 reduced-size liver grafts and 12 split-liver grafts). The overall median follow-up period was 3.5 years. RESULTS: There were no differences in patient and graft survival rates between FSLTx and TVLTx. However, after TVLTx there was a significantly higher complication rate (1.42 vs. 0.81 after FSLTx). TVLTx is more hampered by biliary complications (30% vs. 17%), expressed by a higher incidence of cholangitis and leakage of bile. These complications led to a significantly higher incidence of sepsis (44% vs. 19%) and a significantly higher intervention rate (0.40 vs. 1.28) after TVLTx. There was no difference in the incidence of retransplantations between FSLTx and TVLTx. CONCLUSIONS: Both FSLTx and TVLTx offer the same prognosis in terms of patient and graft survival rates for children after a primary and elective liver transplantation. However, TVLTx has a higher morbidity.
Authors: Ivan R Diamond; Annie Fecteau; J Michael Millis; Julian E Losanoff; Vicky Ng; Ravinder Anand; Changhong Song Journal: Ann Surg Date: 2007-08 Impact factor: 12.969
Authors: Egbert Sieders; Paul M J G Peeters; Elisabeth M TenVergert; Koert P de Jong; Robert J Porte; Jan H Zwaveling; Charles M A Bijleveld; Annette S H Gouw; Maarten J H Slooff Journal: Ann Surg Date: 2002-01 Impact factor: 12.969
Authors: Matteo Cescon; Marco Spada; Michele Colledan; Giuliano Torre; Enzo Andorno; Umberto Valente; Giorgio Rossi; Paolo Reggiani; Umberto Cillo; Umberto Baccarani; Gian Luca Grazi; Giuseppe Tisone; Franco Filipponi; Massimo Rossi; Giuseppe Maria Ettorre; Mauro Salizzoni; Oreste Cuomo; Tullia De Feo; Bruno Gridelli Journal: Ann Surg Date: 2006-11 Impact factor: 12.969
Authors: Stephanie Keeling; Malcolm F McDonald; Adrish Anand; Jordan Dunson; Elizabeth Williams; Theodore Zhang; Brian Hickner; Nhu Thao Nguyen Galván; Christine O' Mahony; John A Goss; Abbas Rana Journal: Can J Gastroenterol Hepatol Date: 2022-09-17