Hyperreduced left lateral living donor liver transplant in a 4.5 kg child-A first in Africa.
ABO incompatibility
acute liver failure
hyperreduced liver graft
living donor liver transplantation
Journal
Pediatric transplantation
ISSN: 1399-3046
Titre abrégé: Pediatr Transplant
Pays: Denmark
ID NLM: 9802574
Informations de publication
Date de publication:
08 2023
08 2023
Historique:
revised:
22
03
2023
received:
13
03
2023
accepted:
13
04
2023
medline:
23
10
2023
pubmed:
16
5
2023
entrez:
16
5
2023
Statut:
ppublish
Résumé
Supply-demand mismatch in solid organ transplantation is particularly pronounced in small children. For liver transplantation, advanced surgical techniques for reducing deceased and living donor grafts allow access to life-saving transplantation. Living donor left lateral segment liver grafts have been successfully transplanted in small children in our center since 2013, the only program providing this service in Sub-Saharan Africa. This type of partial graft remains too large for children below 6 kg body weight and generally requires reduction. A left lateral segment graft was reduced in situ from a directed, altruistic living donor to yield a hyperreduced left lateral segment graft. The donor was discharged after 6 days without complications. The recipient suffered no technical surgical complications except for an infected cut-surface biloma and biliary anastomotic stricture and remains well 9 months post-transplant. We report the first known case in Africa of a hyperreduced left lateral segment, ABO incompatible, living donor liver transplant in a 4,5 kg child with pediatric acute liver failure (PALF).
Sections du résumé
BACKGROUND
Supply-demand mismatch in solid organ transplantation is particularly pronounced in small children. For liver transplantation, advanced surgical techniques for reducing deceased and living donor grafts allow access to life-saving transplantation. Living donor left lateral segment liver grafts have been successfully transplanted in small children in our center since 2013, the only program providing this service in Sub-Saharan Africa. This type of partial graft remains too large for children below 6 kg body weight and generally requires reduction.
METHODS
A left lateral segment graft was reduced in situ from a directed, altruistic living donor to yield a hyperreduced left lateral segment graft.
RESULTS
The donor was discharged after 6 days without complications. The recipient suffered no technical surgical complications except for an infected cut-surface biloma and biliary anastomotic stricture and remains well 9 months post-transplant.
CONCLUSIONS
We report the first known case in Africa of a hyperreduced left lateral segment, ABO incompatible, living donor liver transplant in a 4,5 kg child with pediatric acute liver failure (PALF).
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14536Informations de copyright
© 2023 Wiley Periodicals LLC.
Références
Enne M, Pacheco-Moreira LF, Cerqueira A, et al. Liver transplantation with monosegment from a living donor. Paediatr Transplantation. 2004;8:189-191.
Namgoon N, Hwang S, Song GW, et al. Paediatric liver transplantation with a hyperreduced left lateral segment graft. Ann Hepatobiliary Panc Surg. 2020;24:503-5012.
Ueno T, Toyama C, Deguchi K, et al. Impact of monosegment graft use for infants in paediatric living donor liver transplantation. Transplant Proc. 2022;54:391-394.
Kasahara M, Sakamoto S, Horikawa R, et al. Present state and future prospects of pediatric liver transplantation. JMA J. 2018;1(1):50-56.
Yamada N, Sanada Y, Hirata Y, et al. Selection of living donor liver grafts for patients weighing 6 kg or less. Liver Transpl. 2021;21:233-238.
Tanaka K, Uemoto S, Tokunaga Y, et al. Surgical techniques and innovations in living related liver transplantation. Ann Surg. 1993;217:82-91.
Saintibanes E, McCormack L, Mattera J, et al. Partial left lateral segment transplant from a living donor. Liver Transpl. 2000;6:108-112.
Kasahara M, Fukuda A, Yokoyama S, et al. Living donor liver transplantation with Hyperreduced left lateral segments. J Pediatr Surg. 2008;43:1575-1578.
Housin D, Soubrane O, Boillot O, et al. Orthotopic liver transplantation with reduced sized grafts: an ideal compromise in pediatrics. Surgery. 1992;67:321-327.
Strong R, Lynch S, Yamanaka J, Kawamoto S, Pillay P, Ong TH. Monosegmental liver transplantation. Surgery. 1995;118:904-906.
Mentha G, Belli D, Berner M, et al. Monosegmental liver transplantation from an adult to and infant. Transplantation. 1996;62:1176-1178.
Attia MS, Stringer MD, McClean P, Prasad KR. The reduced left lateral segment in pediatric liver transplantation: an alternative to the monosegment graft. Pediatr Transplantation. 2008;12:696-700.