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Living-donor liver transplantation with monosegments
Mureo Kasahara1, Satoshi Kaihara, Fumitaka Oike
1Organ Transplant Unit, Kyoto University Hospital, Kyoto, Japan. mureo@kuhp.kyoto-u.ac.jp.
Transplantation
|September 16, 2003
Summary
Monosegmental living-donor liver transplantation is a viable option for infants with end-stage liver disease, offering good graft survival despite a higher risk of vascular complications. This technique addresses challenges with large grafts in small recipients.
Area of Science:
- Pediatric Surgery
- Hepatology
- Transplantation Medicine
Background:
- Living-donor liver transplantation (LDLT) is established for pediatric end-stage liver disease.
- Large-for-size grafts pose implantation challenges in small infants.
- Monosegment grafts offer an alternative for specific pediatric cases.
Purpose of the Study:
- To evaluate the feasibility and outcomes of monosegment living-donor liver transplantation in infants.
- To assess graft and patient survival rates in this specific pediatric population.
- To compare donor-related metrics between monosegment and left-lateral segmentectomies.
Main Methods:
- Retrospective analysis of 10 pediatric patients receiving monosegment LDLT.
- Graft selection based on an estimated graft-to-recipient weight ratio exceeding 4.0%.
- Comparison of donor operation time and blood loss with left-lateral segmentectomy cases.
Main Results:
- Achieved 80.0% graft and patient survival.
- No significant difference in donor operation time or blood loss compared to left-lateral segmentectomy.
- A notable incidence of vascular complications (20.0%) was observed in monosegmental transplants.
Conclusions:
- Monosegmental LDLT is a feasible approach for liver transplantation in small infants with liver failure.
- Satisfactory graft survival rates support its use in select pediatric cases.
- Careful monitoring for vascular complications is warranted.