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Pediatric living donor liver transplantation
M López-Santamaria1, E de Vicente, M Gámez
1Unit of Pediatric Liver Transplantation, Department of Pediatric Surgery, La Paz University Hospital, Madrid, Spain. mlopez.hulp@salud.madrid.org
Aim:
The aim of this study was to analyze the results of living donor in a pediatric liver transplantation program.
Patients:
Twenty-six living donor liver transplantations were performed in children from 0.5 to 14.8 years of age. The main indication was biliary atresia (72%) followed by tumors (2 hepatoblastomas and 1 hepatocarcinoma). Left lateral segments were used in 23 (1 transformed into a monosegment), 1 left lobe was used in 1, and right lobes were used in 2. Arterial reconstruction employed saphenous venous grafts in the first 3 cases and end-to-end anastomoses with a microsurgical technique in the following 22 cases.
Results:
There has been no major morbidity in the donors, with a median hospitalization of 6 days. Four grafts have been lost; 2 in the first 3 cases. In only 1 case, the graft loss was related to the procedure saphenous venous graft thrombosis). Early biliary complications were frequent (23%). Six month, 1 year, and 5 year graft and patient survival rates were 91%, 85%, and 85% and 100%, 96%, and 96%, respectively.
Conclusions:
Living donor liver transplantation is an excellent option for transplantation in children.