Unique Identifier
90341893
Authors
Kalayoglu M, D'Alessandro AM, Sollinger HW, Hoffman RM, Pirsch JD,
Belzer FO
Department of Surgery, School of Medicine, University of Wisconsin,
Madison.
Title
Experience with reduced-size liver transplantation.
Source
Surg Gynecol Obstet 1990 Aug;171(2):139-147
Abstract
Orthotopic liver transplantation with reduced-size liver transplants (RLT)
has been proposed as a way of alleviating the limited availability of
size-matched donor organs for pediatric recipients. The use of RLT should
increase the pool of available donors and decrease the number of pediatric
patients who die while awaiting a full-size hepatic graft. Between May
1988 and April 1989, 15 RLT were placed in 12 patients. Twelve were left
lobe and three were extended right lobe grafts. The mean donor to
recipient ratio was 9.0:1.0 (range of 3.3:1.0 to 19.9:1.0). Graft
complications occurred in four RLT, and extrahepatic complications
occurred in five patients. Preservation of grafts with University of
Wisconsin solution was used in all instances, with a mean preservation
time of 14.1 hours (range of 8.5 to 19.5 hours). Retransplantation with
RLT was successful in three of four patients. The actual patient survival
rate was 83 per cent after a mean follow-up interval of 6.7 months (range
of one to 11 months). Our experience indicates that patient survival with
RLT is comparable with full-size grafting and should be offered as an
acceptable method of therapy for end-stage liver disease in pediatric
patients. The application of RLT techniques in a more elective setting may
yield further improvements in patient survival.
MeSH Heading
- Child
- Follow-Up Studies
- Hepatectomy/methods
- Human
|
- Infant
- Liver Transplantation/methods*
- Postoperative Complications
- Prognosis
|
Liver |
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