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[Selection of live donors for segmental liver transplantation in children]
M Sterneck1, U Nischwitz, M Burdelski
1Abteilung für Allgemeinchirurgie, Medizinische Kern- und Poliklinik.
Objective:
To analyse selection criteria and complications in living related donors of liver segments with a view to introducing standardised guidelines for the selection of such donors.
Patients And Methods:
Forty-two mothers and 31 fathers (median age 31 [19-50] years) were tested between October 1991 and July 1994 for their suitability as donors of a liver segment.
Results:
24 of the potential donors (33%) were found not to be suitable. Reasons for this were: poor immunological match of the donor liver as transplant (13), risk factors for thromboembolism (5), and psychological or socioeconomic factors (6). 35 live related donor liver segment transplantations were performed, 34 of the left lateral liver segment, and one of the left liver lobe. The average duration of the operation was 4.5 (3.0-6.0) hours. No foreign blood transfusions were needed. There was one death from pulmonary emboli, and various complications: cerebral seizure (1), gallbladder leak (1), incisional hernia (2) and duodenal ulcer (2).
Conclusion:
Risk of thromboembolism as well as psychological and social factors are the most important exclusion criteria in the selection of donors for live liver segment transplantation.