医学
肝移植
外科
胆道闭锁
吻合
移植
胆汁淤积
内科学
作者
Deniz Balci,Meltem Bingol-Kologlu,Elvan Onur Kirimker,Ergun Ergün,Aydan Kansu,Zarife Kuloğlu,Ceyda Tuna Kırsaçlıoğlu,Suat Fitoz,Özlem Selvi Can,Tanıl Kendirli,Kaan Karayalcin
出处
期刊:Surgery
[Elsevier]
日期:2021-08-01
被引量:2
标识
DOI:10.1016/j.surg.2021.04.015
摘要
Abstract
Background
Monosegmental grafts and reduced left lateral segment grafts have been introduced to overcome the problems of large-for-size grafts in pediatric living donor liver transplantation. Here, we introduce a new method of reduced size monosegment or left lateral segment grafts transplanted in the right diaphragmatic fossa heterotopically in small infants. Methods
There were 4 infants who underwent living donor liver transplantation with heterotopically implanted reduced monosegmental or left lateral segment grafts at our center. The demographic, operative, postoperative, and follow-up data of these infants were collected from our prospectively designed database and reviewed. Technical details of the donor and recipient operation are shared and a supplemental provided. Results
The mean recipient age was 7.5 ± 0.9 months (range: 5–10 months), and body weight was 5.9 ± 0.7 kg (range: 4.6–7.8). Primary diagnoses of the recipients were biliary atresia (n:3) and progressive familial intrahepatic cholestasis (n:1). Mean graft-recipient weight ratio was 3.3 ± 0.2. Reduced monosegment III grafts were used in 2 cases, and reduced left lateral segment grafts were used in the other 2 patients. Bile duct reconstruction was done by Roux-en-Y hepaticojejunostomy in 3 patients and duct-to-duct anastomosis in the remaining patient. All patients recovered from the liver transplantation operation and are doing well at a mean follow-up of 8 months. Conclusion
Living donor liver transplantation with heterotopically implanted reduced monosegmental or left lateral segment seems feasible for the treatment of neonates and extremely small infants. Further accumulation of cases and long-term follow-up are necessary to collect data for the establishment of this treatment modality.
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