Living Related Donor Liver Transplantation in Children

Tannuri, Ana Cristina Aoun; Gibelli, Nelson Elias Mendes; Ricardi, Luiz Roberto Schlaich; Santos, Marcela de Souza; Maksoud‐Filho, João Gilberto; Pinho-Apezzato, M.L.; Silva, M.M.; Velhote, Manoel Carlos Prieto; Ayoub, A.A.R.; Andrade, Wagner de Castro; Leal, Antonio José Gonçalves; Miyatani, Helena Thie; Tannuri, Uenis

doi:10.1016/j.transproceed.2010.11.013

Cited by 40 publications

(29 citation statements)

References 15 publications

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“…They performed 429 pediatric liver transplantations between 1993 and 2010 with the use of four graft types: whole, reduced size, split, and living donor grafts. It was found that most of the biliary complications were anastomotic complications not influenced by the type of graft, which looks contrary to the above‐mentioned authors’ results . In our opinion, the type of the graft (whole, reduced size, split, or living donor) does not necessarily determine the number of bile ducts needs to be anastomosed during liver transplantation.…”

Section: Discussioncontrasting

confidence: 76%

Optimal line of hepatotomy for left lateral living donor liver transplantation according to the anatomical variations of left hepatic duct system

Kiss

Deshpande

Nemeskéri

et al. 2015

Pediatric Transplantation

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Multiple duct anastomoses during LLS transplantation increase the incidence of biliary complications. The optimal plane of hepatotomy that results in the least number of bile ducts at the surface was investigated according to LHD variations. Ducts of 30 human livers were injected with resin and LHD branching on 3D-CT reconstructions were analyzed. Ducts on the virtual hepatotomy surface were estimated in three splitting lines. Variations with subtypes were described. Ia (66.7%): ducts from segments (S.) II-III form a common trunk and S.IV duct joins it. Ib (10%): common trunk formed by ducts from S.II-S.III while S.IV duct joins the common hepatic duct. IIa (16.67%): S.IV duct drains into S.III duct. IIc (3.33%): S.IV duct drains into both S.II and S.III ducts. III (3.33%): trifurcation of S.II, S.III and S.IV ducts. When the virtual hepatotomy line was on the FL, there was a single duct for the anastomosis in 30% of cases but two, three, or four ducts in 53.3%, 10%, and 3.3%, respectively. Division 1 cm to the right of the FL resulted in one duct (70%), but S.IV duct injury may occur. LLS hepatotomy should not necessarily be performed along the FL. Variations must be taken into consideration to minimize the number of biliary anastomoses during liver implantation.

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Section: Discussioncontrasting

confidence: 76%

Optimal line of hepatotomy for left lateral living donor liver transplantation according to the anatomical variations of left hepatic duct system

Kiss

Deshpande

Nemeskéri

et al. 2015

Pediatric Transplantation

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“…This resolution may take a relatively short time, three months as in our patient, or over a year as reported in some cases [12]. A recent study reported that living-related donor liver transplantation in children was associated with a high survival rate, and it included three cases of patients with congenital hepatic fibrosis [13]. …”

Section: Discussionsupporting

confidence: 63%

Unexplained cyanosis revealing hepatopulmonary syndrome in a child with asymptomatic congenital hepatic fibrosis: a case report

et al. 2013

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IntroductionHepatopulmonary syndrome is a rare disease that affects patients of any age with acute or chronic liver disease. Liver transplantation is the only therapeutic option of proved benefit, and can result in substantial improvement or total improvement in postoperative gas exchange abnormalities.Case presentationWe report the case of a cyanotic 13-year-old Pakistani boy whose chest computed tomography scan showed normal lung fields and mediastinum with incidental findings of a prominent liver surface with a collateral vein connecting a portal cavernoma to the dilated terminal inferior vena cava. Sonography of his abdomen along with a portal venous Doppler study showed multiple collateral veins replacing the portal vein. A liver biopsy revealed congenital hepatic fibrosis. Contrast-enhanced echocardiography with agitated saline and a 99m Technetium-macroaggregated albumin perfusion lung scan confirmed intrapulmonary shunting. The patient underwent a successful liver transplantation that resulted in improved gas exchange.ConclusionsHepatopulmonary syndrome should be included in the differential diagnosis of unexplained hypoxemia with an evaluation of possible portal hypertension or liver disease even in the absence of other clinical symptoms.

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“…Additionally, there are virtually no data regarding the safety of using heterozygous A1AT donors in LT. Roelandt et al found that 0.8% of presumed healthy transplanted livers in their study group were heterozygous for A1AT . A few cases of LDLT have been performed, but no details are available regarding specific outcomes or longterm follow‐up . Heterozygosity may accelerate progression of disease in concurrent liver conditions.…”

Section: Alpha‐1‐antitrypsin Deficiencymentioning

confidence: 94%

“…No available data A1AT deficiency Insufficient evidence (35,36,79) No available data Insufficient evidence (37)(38)(39)(80)(81)(82)(83)(84)…”

Section: G6pd Deficiencymentioning

confidence: 99%

Genetic, hematological, and immunological disorders transmissible with liver transplantation

Tan¹,

Florman

Schiano

2017

Liver Transpl

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It is well recognized that solid organ transplantation can transmit bacterial infection and chronic viral hepatitis as well as certain cancers. As indications for liver transplantation (LT) have expanded, it has been used to treat and even cure certain genetic cholestatic disorders, urea cycle defects, and coagulation abnormalities; many of these conditions are potentially transmissible with LT as well. It is important for clinicians and transplant patients to be aware of these potentially transmissible conditions as unexplained post-LT complications can sometimes be related to donor transmission of disease and thus should prompt a thorough exploration of the donor allograft history. Herein, we will review the reported genetic, metabolic, hematologic, and immunological disorders that are transmissible with LT and describe clinical scenarios in which these cases have occurred, such as in inadvertent or recognized transplantation of a diseased organ, domino transplantation, and with living related liver donation. Liver Transplantation 23 663-678 2017 AASLD.

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Living Related Donor Liver Transplantation in Children

Cited by 40 publications

References 15 publications

Optimal line of hepatotomy for left lateral living donor liver transplantation according to the anatomical variations of left hepatic duct system

Optimal line of hepatotomy for left lateral living donor liver transplantation according to the anatomical variations of left hepatic duct system

Unexplained cyanosis revealing hepatopulmonary syndrome in a child with asymptomatic congenital hepatic fibrosis: a case report

Genetic, hematological, and immunological disorders transmissible with liver transplantation

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