Living-donor liver transplant with a left lateral segment for small pediatric patients is a well-accepted procedure; however, the size of the graft may be too large, especially for children weighing less than 10 kg and aged younger than 1 year. In this study, we evaluate our experience with left lateral segment liver graft. Since September 2001, 111 liver transplants have been done in 108 children at our center. Living-donor liver transplant was done using the donor’s left lateral segment in 65 children. Children were divided into 2 groups: group 1 consisted of 33 children who had graft-to-recipient weight ratios less than 3%, and group 2 consisted of 32 children who had graft-to-recipient weight ratios of 3% or more. Results: The median weights of the children in groups 1 and 2 were 1.2 kg. The median graft-to-recipient weight ratios in groups 6.6 kg and 7.618.5 0.8. Postoperative complications, acute rejection 0.6 and 4.11 and 2 were 1.9 rates, and graft and patient survival rates were similar in both groups. Delayed abdominal closure was required in 1 child in each group. None of children required mechanical ventilation postoperatively. Daily Doppler ultrasonographic evaluations show no size-related graft perfusion problems. During a mean 20.4 months, 8 children died (5 in group 1 and 3 in group 2). Follow-up of 29.6 The remaining 57 children (90.4%) are alive at the time of this writing with good graft functioning. Left lateral segment living-donor liver transplant is feasible for small babies with liver failure who weigh less than 10 kg and are aged younger than 1 year. Grafts with graft-to-recipient weight ratios larger than 3% may be used safely in children. This is significant clinically because it decreases the unnecessary need to reduce graft size, which may be time consuming and can lead to complications.
Volume : 6
Issue : 4
Pages : 15
Department of General Surgery and Transplantation, Baskent University Faculty of Medicine, Ankara, Turkey