Related Experiment Video
Updated: Jun 10, 2026
Porcine Liver Transplantation Without Veno-Venous Bypass As an Extended Criteria Donor Model
Published on: August 17, 2022
[Living donation liver transplantation in children]
B Dresske1, M Schulze, F Braun
1Klinik für Allgemeine Chirurgie und Thoraxchirurgie, Universitätsklinikum Schleswig-Holstein, Kiel, Deutschland. bettina.dresske@uksh-kiel.de
Insights
Living donor liver transplantation offers excellent outcomes for children with liver failure, utilizing smaller liver segments to overcome organ shortages. This approach significantly reduces waiting list deaths and ensures high survival rates for pediatric patients.
Area of Science:
- Hepatology
- Pediatric Surgery
- Transplantation Medicine
Context:
- Pediatric liver transplantation is crucial for end-stage liver disease, metabolic disorders, and tumors in children.
- Limited availability of deceased donor organs for small pediatric recipients necessitates alternative strategies.
- Living donor liver transplantation (LDLT) has emerged as a vital solution to address organ scarcity.
Purpose:
- To evaluate the efficacy and safety of living donor liver transplantation in pediatric patients.
- To highlight the suitability of left lateral lobe grafts for small children (<25 kg).
- To emphasize the importance of standardized procedures and multidisciplinary teams in pediatric LDLT.
Summary:
- Living liver donation has dramatically reduced waiting list mortality in pediatric liver transplantation, achieving excellent patient and graft survival.
- The left lateral lobe (segments II+III) is often sufficient for pediatric recipients, facilitating successful living donation.
- Standardized surgical and perioperative management has made left lateral lobe donation a safe procedure with minimal donor risk.
Impact:
- LDLT effectively overcomes organ donor limitations for pediatric liver failure, improving access to life-saving treatment.
- The procedure demonstrates high success rates, comparable to deceased donor transplants, with improved quality of life for recipients.
- Complex pediatric liver diseases require specialized pediatric teams and high-volume transplant centers for optimal outcomes.
Abstract:
Liver transplantation is the first-line therapy for children with acute and chronic hepatic failure, metabolic liver diseases and liver tumors. As most of the children with end-stage liver disease are very small in stature the resources of compatible organs of deceased donors are limited. Living liver donation was able to nearly eliminate waiting list mortality with excellent patient and graft survival. As 80% of the pediatric recipients have a body weight <25 kg donation of the left lateral lobe (segments II+III) is sufficient in most of the cases. According to a standardization of the surgical procedures as well as the preoperative, intraoperative and postoperative management donation of the left lateral lobe advanced to a procedure with very low donor morbidity and mortality rates. The complexity of hepatic disease patterns in pediatric patients which often affect other organ systems demand a close cooperation with an experienced pediatric team. Pediatric living donor liver transplantation requires high expertise in liver surgery and split liver transplantation and should therefore only be performed in transplant centers meeting these high qualifications.
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