Successful segmental auxiliary liver transplantation from a non-heart-beating donor: implications for split-liver transplantation

Muiesan, Paolo; Girlanda, Raffaele; Baker, Alistair; Rela, Mohamed; Heaton, Nigel

doi:10.1097/01.tp.0000069024.86527.0b

Cited by 20 publications

(14 citation statements)

References 5 publications

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“…In comparison, most liver donors were children, likely related to the necessity of matching graft to recipient size in younger children with liver disease. Recently successful split liver transplantation from DCDs into children has been reported by the group at King's College (16,17).…”

Section: Discussionmentioning

confidence: 98%

Pediatric Liver and Kidney Transplantation With Allografts From DCD Donors: A Review of UNOS Data

Abt¹,

Kashyap²,

Orloff³

et al. 2006

Transplantation

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Section: Discussionmentioning

confidence: 98%

Pediatric Liver and Kidney Transplantation With Allografts From DCD Donors: A Review of UNOS Data

Abt¹,

Kashyap²,

Orloff³

et al. 2006

Transplantation

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“…Livers recovered from controlled NHBDs have been utilized in our center to transplant adult recipients with early results, which are comparable to those reported from deceased heart-beating donation (3). Our increasing clinical practice has enabled us to identify NHBD livers likely to provide good graft function, which are potentially suitable for bench reduction and segmental transplantation (4). We report our early experience of seven cases of successful segmental liver transplants in children from controlled NHBDs.…”

Section: Introductionmentioning

confidence: 99%

Segmental Liver Transplantation from Non-Heart Beating Donors—An Early Experience with Implications for the Future

Muiesan

Jassem

Girlanda

et al. 2006

American Journal of Transplantation

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We report our experience of pediatric liver transplantation with partial grafts from non-heart beating donors (NHBD). Controlled donors less than 40 years of age with a warm ischemia time (WI) of less than 30 min were considered for pediatric recipients. Death was declared 5 min after asystole. A super-rapid recovery technique with aortic and portal perfusion was utilized. Mean donor age was 29 years and WI 14.6 min (range 11-18). Seven children, mean age 4.9 years (0.7-11), median weight 20 kg (8.4-53) received NHBD segmental liver grafts. Diagnoses included seronegative hepatitis, neonatal sclerosing cholangitis, familial intrahepatic cholestasis, hepatoblastoma, primary hyperoxaluria and factor VII deficiency (n = 2).The grafts included four reduced and one split left lateral segments, one left lobe and one right auxiliary graft. Mean cold ischemia was 7.3 h (6.2-8.8). Complications included one pleural effusion and one biliary collection drained percutaneously. At 20 months (10-36) followup all children are alive and well with functioning grafts. Donation after cardiac death is a significant source of liver grafts for adults and children with careful donor selection and short cold ischemic times.

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“…It has been reported cases of successful LT with DCD donors both with whole and segmental livers with good results (1, 2, 7). These segmental grafts can also be used as auxiliary grafts in fulminant hepatitis (8). The main concerns when using these grafts are the increased rate of ischemic cholangiopathy with intrahepatic biliary strictures (9).…”

Section: Discussionmentioning

confidence: 99%

Segmental ABO‐incompatible liver graft from a donor after cardiac death in neonatal acute liver failure

Gelas

Hartley

Mirza

et al. 2011

Pediatric Transplantation

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Segmental liver grafts from DCD in pediatric LT have been safely used even in acute liver failure situations. Furthermore, despite the risk of antibody-mediated acute rejection, some studies have also demonstrated the safety of ABO incompatible LT in infants. The use of such grafts can be beneficial by reducing the time on the transplant waiting list but they are more susceptible to initial dysfunction and there is a lack of enthusiasm to consider their use especially for an emergency LT as a life-saving procedure. In this short article, we describe the use and successful outcome in a neonate with fulminant acute liver failure secondary to neonatal hemochromatosis who received an ABO-incompatible reduced-size DCD graft.

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Successful segmental auxiliary liver transplantation from a non-heart-beating donor: implications for split-liver transplantation

Abstract: Reduction and splitting of livers from NHBDs for transplantation is a realistic option, provided there is careful selection of the graft.

Cited by 20 publications

References 5 publications

Pediatric Liver and Kidney Transplantation With Allografts From DCD Donors: A Review of UNOS Data

Pediatric Liver and Kidney Transplantation With Allografts From DCD Donors: A Review of UNOS Data

Segmental Liver Transplantation from Non-Heart Beating Donors—An Early Experience with Implications for the Future

Segmental ABO‐incompatible liver graft from a donor after cardiac death in neonatal acute liver failure

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