Implications for the usage of the left lateral liver graft for infants ≤10 kg, irrespective of a large‐for‐size situation – are monosegmental grafts redundant?

Summary Organ donor shortage for infant liver transplant recipients has lead to an increase in splitting and living donation. For cases in which even transplantation of the left lateral graft (Couinaud’s segments II + III) results in a “large for size situation” with an estimated graft body weight r...

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Bibliographic Details
Published in:Transplant international 2011-08, Vol.24 (8), p.797-804
Main Authors: Schulze, Maren, Dresske, Bettina, Deinzer, Julia, Braun, Felix, Kohl, Martina, Schulz‐Jürgensen, Sebastian, Borggrefe, Jan, Burdelski, Martin, Bröring, Dieter Clemens
Format: Article
Language:English
Subjects:
Abdomen
Adolescent
biliary complications
Birth Weight
Body Weight
Child
Child, Preschool
Critical Care
Female
graft body weight ratio
Humans
Infant, Newborn
Intraabdominal Infections - etiology
intraoperative ultrasound
large‐for‐size
Liver - diagnostic imaging
Liver - pathology
Liver Transplantation - methods
Living Donors
Male
Necrosis
temporary abdominal closure
Transplants & implants
Ultrasonography - methods
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Summary:Summary Organ donor shortage for infant liver transplant recipients has lead to an increase in splitting and living donation. For cases in which even transplantation of the left lateral graft (Couinaud’s segments II + III) results in a “large for size situation” with an estimated graft body weight ratio (GBWR) of >4%, monosegmental liver transplantation was developed. This, however, bears complications because of greater parenchymal surface and suboptimal vascular flow. We exclusively use the left lateral graft from living donors or split grafts. Temporary abdominal closure is attempted in cases of increased pressure. We report of 41 pediatric transplants in 38 children ≤10 kg. Within this group, there were 23 cases with a GBWR of ≥4, and 15 cases with a GBWR
ISSN:0934-0874
1432-2277
DOI:10.1111/j.1432-2277.2011.01277.x