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Liver replacement with reduced size donor organs.

I R Marino1, G De Luca, S Celli

  • 1Department of Surgery, Catholic University of Rome, Italy.

Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research
|January 1, 1988
PubMed
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Resected adult donor livers can be used for pediatric orthotopic liver transplantation (OLT). This technique addresses donor shortages, showing comparable postoperative outcomes to standard OLT in a pig model.

Area of Science:

  • Hepatology
  • Transplantation Surgery
  • Pediatric Surgery

Background:

  • End-stage liver disease in children often requires orthotopic liver transplantation (OLT).
  • A significant barrier to OLT expansion in Europe is the scarcity of size-matched pediatric donors.
  • Utilizing reduced-size adult donor livers presents a potential solution to this donor organ shortage.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of using in situ resected adult donor liver grafts for pediatric orthotopic liver transplantation (OLT).
  • To compare the postoperative course and biochemical parameters between standard OLT and OLT using reduced-size grafts.

Main Methods:

  • Two groups of Landrace pigs underwent orthotopic liver transplantation (OLT).
  • Group 1: 20 standard donor/recipient weight-matched OLT.

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  • Group 2: 15 OLT using 55% of the donor liver (right lateral and medial lobes), with in situ resection under normothermic conditions before harvesting to minimize cold ischemia time.

    • Main Results:

    • No significant technical challenges were encountered during the in situ resection and transplantation procedures.
    • Postoperative biochemical results in the group receiving reduced-size grafts (Group 2) were analogous to the standard OLT group (Group 1).
    • The donor/recipient weight ratio in Group 2 was 2:1, with cold ischemia times comparable to Group 1.

    Conclusions:

    • In situ resection of adult donor livers is a technically feasible approach for creating reduced-size grafts.
    • Reduced-size adult donor liver grafts demonstrate comparable postoperative recovery and metabolic function to standard grafts in OLT.
    • This technique offers a promising strategy to increase the availability of donor organs for pediatric liver transplantation.