Living donor liver transplantation with hyperreduced left lateral segments
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Published on: August 17, 2022
Mureo Kasahara1, Akinari Fukuda, Satoshi Yokoyama
1Department of Transplant Surgery, National Center for Child Health and Development, Tokyo 157-8535, Japan. kasahara-m@ncchd.go.jp
Insights
Hyperreduced left lateral segment liver grafts offer a viable solution for pediatric end-stage liver disease, addressing the challenge of large-for-size grafts in infants. This technique provides an alternative surgical approach for living donor liver transplantation in small children.
Area of Science:
- Pediatric Surgery
- Hepatology
- Organ Transplantation
Background:
- Pediatric liver transplantation utilizes left lateral segment grafts (segments II and III).
- Large-for-size grafts pose challenges in small infants undergoing liver transplantation.
- Reduced left lateral segmental liver transplantation was developed to address this issue.
Purpose of the Study:
- To evaluate the feasibility and application of hyperreduced left lateral segment grafts in pediatric living donor liver transplantation.
- To present surgical experiences with hyperreduced grafts as an alternative technique for infants with end-stage liver disease.
Main Methods:
- Surgical technique involving further reduction of left lateral segment liver grafts.
- Living donor liver transplantation performed in three pediatric cases using hyperreduced grafts.
Main Results:
- Successful transplantation in three infants using hyperreduced left lateral segment grafts.
- Demonstrated the possibility of supplying adequate hyperreduced grafts for small infants.
Conclusions:
- Hyperreduced left lateral segment grafts are a viable alternative surgical technique for pediatric liver transplantation.
- This approach effectively mitigates the problem of large-for-size grafts in infants requiring liver transplants.
Abstract:
Liver transplantation is now an established technique to treat children with end-stage liver disease. Implantation of left lateral segment grafts (Couidaud's segments II and III) can be a problem in small infants because of a large-for-size graft. Reduced left lateral segmental liver transplantation has been recently introduced for small infants to mitigate the problem of large-for-size graft. Further reduction of the left lateral segment graft increases the possibility of supplying an adequate hyperreduced left lateral segment graft as an alternative surgical technique. We report 3 cases of our experience of transplantation using hyperreduced left lateral segment grafts from living donors.
