Pediatric liver transplantation with hyperreduced left lateral segment graft

Jung-Man Namgoong; Shin Hwang; Gi-Won Song; Dae-Yeon Kim; Tae-Yong Ha; Dong-Hwan Jung; Gil-Chun Park; Chul-Soo Ahn; Kyung Mo Kim; Seak Hee Oh; Hyunhee Kwon; Yong Jae Kwon

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자료유형: 학술저널

저자정보: Jung-Man Namgoong (University of Ulsan College of Medicine) Shin Hwang (University of Ulsan College of Medicine) Gi-Won Song (University of Ulsan College of Medicine) Dae-Yeon Kim (University of Ulsan College of Medicine) Tae-Yong Ha (University of Ulsan College of Medicine) Dong-Hwan Jung (University of Ulsan College of Medicine) Gil-Chun Park (University of Ulsan College of Medicine) Chul-Soo Ahn (University of Ulsan College of Medicine) Kyung Mo Kim (University of Ulsan College of Medicine) Seak Hee Oh (University of Ulsan College of Medicine) Hyunhee Kwon (University of Ulsan College of Medicine) Yong Jae Kwon (University of Ulsan College of Medicine)

저널정보: 한국간담췌외과학회 Annals of Hepato-Biliary-Pancreatic Surgery 한국간담췌외과학회지 제24권 제4호

발행연도: 2020.11

수록면: 503 - 512 (10page)

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Backgrounds/Aims: To prevent large-for-size graft-related complications in small infant patients, the size of a left lateral segment (LLS) graft can be reduced to be a hyperreduced LLS (HRLLS) graft. Methods: This study was intended to describe the detailed techniques for harvesting and implanting HRLLS grafts developed in a high-volume liver transplantation (LT) center. Results: The mean recipient age was 4.0±1.7 months (range: 3-6) and body weight was 5.3±1.4 kg (range: 4.1-6.9). Primary diagnoses of the recipients were progressive familial intrahepatic cholestasis in 2 and biliary atresia in 1. The types of LT were living donor LT in 1 and split deceased donor LT in 2. Non-anatomical size reduction was performed to the transected LLS grafts. The mean weight of the HRLLS grafts was 191.7±62.1 g (range: 120-230) and graft-recipient weight ratio was 3.75±1.57% (range: 2.45-5.49). Widening venoplasty was applied to the graft left hepatic vein outflow orifice. Vein homograft interposition was used in a case with portal vein hypoplasia. Types of the abdomen wound closure were one case of primary repair, one of two-staged closure with a mesh, and one of three-staged repair with a silo and a mesh. All three patients recovered uneventfully from the LT operation and are doing well to date for more than 6 years after transplantation. Conclusions: Making a HRLLS graft through non-anatomical resection during living donor LT and split deceased donor LT can be a useful option for treating small infant patients.

#Infant #Large-for-size graft #Pediatric transplantation #Graft-recipient weight ratio #Left lateral segment

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