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Successful Orthotopic Liver Transplantation in Mice Utilizing Microcomputed Tomography Angiography
Published on: September 22, 2023
Liver transplantation for small babies
H Karakayali1, F Ozcay, S Sevmis
1Department of General Surgery, Başkent University Faculty of Medicine, Ankara, Turkey.
Insights
Living-related liver transplants in infants under 10 kg offer a reliable solution. Despite surgical challenges, 81% of pediatric patients showed good graft function post-transplant.
Area of Science:
- Pediatric Surgery
- Transplantation Immunology
- Hepatology
Background:
- Orthotopic liver transplantation in infants presents significant medical and surgical challenges.
- Small pediatric patients (<10 kg or <1 year) require specialized approaches for liver transplantation.
Purpose of the Study:
- To evaluate the outcomes of orthotopic liver transplantation in small pediatric patients using living-related donors.
- To assess the feasibility and success rates of liver transplantation in infants.
Main Methods:
- A cohort of 21 infants (<10 kg or <1 year) underwent orthotopic liver transplantation between April 2003 and June 2006.
- All grafts were from living-related donors, utilizing the left lateral segment.
- Graft-to-recipient weight ratio and postoperative complications were monitored.
Main Results:
- The study included 16 boys and 5 girls with a mean age of 15.7 months and weight of 9.8 kg.
- Early complications included hepatic arterial thrombosis (4 patients) and biliary leak (2 patients). Late complication was portal vein stenosis (2 patients).
- At follow-up (median 14.8 months), 17 patients (81%) had good graft function. Four patients died; 3 with malignancies (2 hepatocellular carcinoma, 1 Burkitt's lymphoma).
Conclusions:
- Living-related donors are a dependable source for pediatric liver organs, particularly for infants.
- Satisfactory outcomes are achievable in infant liver transplantation despite anatomical difficulties.
- This approach provides a viable option for managing liver failure in the youngest patients.
Abstract:
Orthotopic liver transplantation remains a major medical and surgical challenge in small pediatric patients. From April 2003 to June 2006, 21 small babies (each of whom weighed less than 10 kg or was younger than 1 year of age) underwent orthotopic liver transplantation. Five were girls and 16 were boys with a mean age of 15.7 +/- 9.3 months (range, 2-24 months); their mean weight at the time of transplantation was 9.8 +/- 3.6 kg (range, 6-16 kg). All transplants were obtained from a living-related donor. Left lateral segment was used for all transplantations. The median graft-to-recipient weight ratio was 3.5% +/- 1.2% (range, 1.5%-6.1%). During the early postoperative period, hepatic arterial thrombosis was identified in 4 patients, and a biliary leak was detected in 2 patients. In 2 patients, portal vein stenosis was identified during the late postoperative period. At the time of this writing, the 17 alive patients (81%) exhibited good graft function at median follow-up of 14.8 +/- 10.9 months (range, 1-39 months). Four patients died during the follow-up. Histological examination revealed hepatocellular carcinoma in 2 patients, and Burkitt's lymphoma in 1 patient. In conclusion, our data confirmed that living-related donors, especially in this age group, provide a reliable source for the organ pool. Satisfactory results can be achieved despite the anatomic handicaps of this age group.
