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Living-donor liver transplantation in children
1The Recanati/Miller Transplantation Institute,The Mount Sinai School of Medicine, New York, New York 10029, USA. sukru.emre@mountsinai.org
Insights
Pediatric liver transplantation survival rates are high (85-90%). Living donor liver transplantation is increasingly used to reduce wait times and improve outcomes for children awaiting transplants.
Area of Science:
- Pediatric surgery
- Transplantation immunology
- Hepatology
Background:
- Pediatric liver transplantation survival rates have improved significantly, reaching 85-90% at one year.
- Increased patient listings have led to longer waiting times for liver transplants.
- Innovative techniques like reduced-size, split, and living-donor grafts are crucial for managing waitlists.
Purpose of the Study:
- To review the current status of living donor liver transplantation in pediatric patients.
- To discuss critical aspects of pediatric living donor liver transplantation, including donor and recipient selection.
- To address the surgical procedures and ethical considerations involved in pediatric living donor liver transplantation.
Main Methods:
- This is a review article, synthesizing existing literature on pediatric living donor liver transplantation.
- The review focuses on donor and recipient selection criteria.
- Surgical techniques for both donors and recipients are examined, alongside ethical considerations.
Main Results:
- Living donor liver transplantation is a viable option for pediatric patients, helping to mitigate long waiting times.
- Careful donor and recipient selection is paramount for successful outcomes.
- Ethical considerations are integral to the implementation of living donor liver transplantation in children.
Conclusions:
- Living donor liver transplantation offers a valuable alternative for pediatric liver transplant candidates.
- Advances in surgical techniques and immunosuppression support the success of pediatric liver transplantation.
- Careful management of donor, recipient, surgical, and ethical issues is essential for optimizing outcomes in pediatric living donor liver transplantation.
Abstract:
With evolution of surgical technique, advances in immunosuppression, and better understanding of pre- and post-operative care, the 1-yr survival rate after liver transplantation in children has reached 85-90%. As a result, a greater number of patients have been listed for transplantation and waiting times have lengthened. Innovative techniques such as reduced-size, split, and living-donor liver transplantation are being applied more often to decrease long waiting times and reduce associated morbidity and mortality. In this review, living donor liver transplantation in pediatrics is described. Special issues, such as donor and recipient selection, surgical procedures in donors and recipients, and ethical issues, are discussed.