BACKGROUND: We had previously described a left lateral segment hyper-reduction technique capable of sizing the graft according to the volume of the abdominal cavity of the recipient. AIM: The purpose of our study was to evaluate our 14-year live-donor liver transplantation experience with in situ graft hyper-reduction in children under 10 kg of weight. PATIENTS AND METHODS: Between January 1997 and May 2011, we performed 881 liver transplants. Two hundred and seventy-seven (n = 277) involved pediatric recipients, of which 102 (37 %) were from live donors. Thirty-five (n = 35) patients under 10 kg of weight underwent hyper-reduced living donor liver transplants. There were 21 females (60 %) and 14 males (40 %), with a median age of 12 months (range 3-23) and a median weight of 7.7 kg (range 5.6-10). RESULTS: Median operative time was 350 min (range 180-510). Median cold ischemia time was 180 min (range 60-300). Twenty-six (n = 26) patients required intraoperative transfusion of blood products. There were 49 postoperative complications involving 26 patients (74 % morbidity rate). One-, 3-, and 5-year survival rates were 87, 79, and 74 %, respectively. Twenty-eight patients are currently alive. CONCLUSIONS: Hyper-reduced grafts provide an alternative approach for low-weight pediatric recipients. The relatively high immediate postoperative morbidity could be related to the complexity of these patients.
BACKGROUND: We had previously described a left lateral segment hyper-reduction technique capable of sizing the graft according to the volume of the abdominal cavity of the recipient. AIM: The purpose of our study was to evaluate our 14-year live-donor liver transplantation experience with in situ graft hyper-reduction in children under 10 kg of weight. PATIENTS AND METHODS: Between January 1997 and May 2011, we performed 881 liver transplants. Two hundred and seventy-seven (n = 277) involved pediatric recipients, of which 102 (37 %) were from live donors. Thirty-five (n = 35) patients under 10 kg of weight underwent hyper-reduced living donor liver transplants. There were 21 females (60 %) and 14 males (40 %), with a median age of 12 months (range 3-23) and a median weight of 7.7 kg (range 5.6-10). RESULTS: Median operative time was 350 min (range 180-510). Median cold ischemia time was 180 min (range 60-300). Twenty-six (n = 26) patients required intraoperative transfusion of blood products. There were 49 postoperative complications involving 26 patients (74 % morbidity rate). One-, 3-, and 5-year survival rates were 87, 79, and 74 %, respectively. Twenty-eight patients are currently alive. CONCLUSIONS: Hyper-reduced grafts provide an alternative approach for low-weight pediatric recipients. The relatively high immediate postoperative morbidity could be related to the complexity of these patients.
Authors: E de Santibañes; L McCormack; J Mattera; J Pekolj; J Sívori; A Beskow; D D'Agostino; M Ciardullo Journal: Liver Transpl Date: 2000-01 Impact factor: 5.799
Authors: T Kiuchi; M Kasahara; K Uryuhara; Y Inomata; S Uemoto; K Asonuma; H Egawa; S Fujita; M Hayashi; K Tanaka Journal: Transplantation Date: 1999-01-27 Impact factor: 4.939
Authors: M Kasahara; K Uryuhara; S Kaihara; K Kozaki; Y Fujimoto; Y Ogura; K Ogawa; F Oike; M Ueda; H Egawa; K Tanaka Journal: Transplant Proc Date: 2003-06 Impact factor: 1.066
Authors: K Tanaka; S Uemoto; Y Tokunaga; S Fujita; K Sano; T Nishizawa; H Sawada; I Shirahase; H J Kim; Y Yamaoka Journal: Ann Surg Date: 1993-01 Impact factor: 12.969
Authors: Marcelo Enne; Lucio Filgueiras Pacheco-Moreira; Alexandre Cerqueira; Elizabeth Balbi; Marcia Halpern; João Luiz Pereira; Giuseppe Santalucia; Josther Gracia; Flavia Goncalves Coelho De Souza E Oliveira; Grace Kelly Paranhos; Rosalice Miecznikowski; Lucio José Auler De Faria; Rodrigo Pereira Diaz André; Adriana Caroli Bottino; José Manoel Martinho Journal: Pediatr Transplant Date: 2004-04
Authors: Micaela Raices; Matias Eduardo Czerwonko; Victoria Ardiles; Gustavo Boldrini; Daniel D'Agostino; José Marcó Del Pont; Juan Pekolj; Juan Mattera; Claudio Brandi; Miguel Ciardullo; Eduardo de Santibañes; Martin de Santibañes Journal: J Gastrointest Surg Date: 2019-03-18 Impact factor: 3.452