Living Donor-Initiated Domino Split-Liver Transplantation in Pediatric Setup: A Case Report With Literature Review.


Journal

Transplantation proceedings
ISSN: 1873-2623
Titre abrégé: Transplant Proc
Pays: United States
ID NLM: 0243532

Informations de publication

Date de publication:
Oct 2023
Historique:
received: 04 07 2023
accepted: 31 07 2023
medline: 10 10 2023
pubmed: 31 8 2023
entrez: 30 8 2023
Statut: ppublish

Résumé

In patients undergoing liver transplantation for metabolic diseases, removing the patient's liver for transplantation to another recipient is called "domino liver transplantation." The extracted liver can be divided and transplanted into 2 recipients, which is called domino split-liver transplantation in the literature. However, in our study, the domino liver was obtained from a pediatric patient. A patient with maple syrup urine disease (MSUD) underwent a living donor liver transplant, and the explanted liver was divided in situ into right and left lobes and transplanted to 2 separate patients. Demographic data, surgical techniques, postoperative period, and patient follow-ups were evaluated. The father's left lobe liver graft was transplanted into a 12-year-old boy with MSUD. The removed liver was divided in situ into right and left lobes. The left lobe was transplanted to a 14-year-old male patient, whereas the right lobe was transplanted to a 67-year-old male patient. The donor and the first recipient were discharged on postoperative days 5 and 22. The second pediatric patient who underwent domino split-left lobe transplantation was discharged on postoperative day 23. The adult patient who underwent domino split-right lobe transplantation died on postoperative day 12 owing to massive esophageal variceal bleeding. Patients who underwent liver transplantation due to MSUD are among the best donor choices for domino liver transplantation. If the extracted liver has a sufficient volume and anatomic features for a split, it can be used in "selected cases."

Sections du résumé

BACKGROUND BACKGROUND
In patients undergoing liver transplantation for metabolic diseases, removing the patient's liver for transplantation to another recipient is called "domino liver transplantation." The extracted liver can be divided and transplanted into 2 recipients, which is called domino split-liver transplantation in the literature. However, in our study, the domino liver was obtained from a pediatric patient.
METHODS METHODS
A patient with maple syrup urine disease (MSUD) underwent a living donor liver transplant, and the explanted liver was divided in situ into right and left lobes and transplanted to 2 separate patients. Demographic data, surgical techniques, postoperative period, and patient follow-ups were evaluated.
RESULTS RESULTS
The father's left lobe liver graft was transplanted into a 12-year-old boy with MSUD. The removed liver was divided in situ into right and left lobes. The left lobe was transplanted to a 14-year-old male patient, whereas the right lobe was transplanted to a 67-year-old male patient. The donor and the first recipient were discharged on postoperative days 5 and 22. The second pediatric patient who underwent domino split-left lobe transplantation was discharged on postoperative day 23. The adult patient who underwent domino split-right lobe transplantation died on postoperative day 12 owing to massive esophageal variceal bleeding.
CONCLUSION CONCLUSIONS
Patients who underwent liver transplantation due to MSUD are among the best donor choices for domino liver transplantation. If the extracted liver has a sufficient volume and anatomic features for a split, it can be used in "selected cases."

Identifiants

pubmed: 37648577
pii: S0041-1345(23)00480-3
doi: 10.1016/j.transproceed.2023.07.017
pii:
doi:

Types de publication

Review Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1934-1937

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest All authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Altan Alim (A)

Department of Liver Transplantation, Koc University Hospital, Istanbul, Turkey.

Cihan Karataş (C)

Department of Liver Transplantation, Koc University Hospital, Istanbul, Turkey. Electronic address: ckaratas@kuh.ku.edu.tr.

Akın Akbulut (A)

Department of Anesthesiology, Koc University Hospital, Istanbul, Turkey.

Bahadır Hakan Oğuz (BH)

Department of Anesthesiology, Koc University Hospital, Istanbul, Turkey.

Ömer Özden (Ö)

Department of Pediatric Intensivist, Koc University Hospital, Istanbul, Turkey.

Şenol Emre (Ş)

Istanbul Cerrahpasa University Hospital, Department of Pediatric Surgery, Istanbul, Turkey.

Gültekin Hoş (G)

Sisli Etfal Training and Research Hospital, Department of Liver Transplantation, İstanbul, Turkey.

Barış Demir (B)

Department of Liver Transplantation, Koc University Hospital, Istanbul, Turkey.

Nuray Uslu Kızılkan (NU)

Department of Pediatric Gastroenterology, Koc University Hospital, Istanbul, Turkey.

Aydın Alper (A)

Department of Liver Transplantation, Koc University Hospital, Istanbul, Turkey.

Turan Kanmaz (T)

Department of Liver Transplantation, Koc University Hospital, Istanbul, Turkey.

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