Forty-four living donor liver transplantations for children with biliary atresia
10.3760/cma.j.issn.0254-1785.2011.07.010
- VernacularTitle:活体肝移植治疗儿童胆道闭锁44例
- Author:
Jianjun ZHU
;
Qiang XIA
;
Jianjun ZHANG
;
Qigen LI
;
Ning XU
;
Xiaosong CHEN
;
Feng XUE
;
Longzhi HAN
;
Lei XIA
;
Xin WANG
;
Yi LUO
;
Conghuan SHEN
;
Tianyu XING
;
Zhifeng XI
- Publication Type:Journal Article
- Keywords:
Child;
Biliary atresia;
Liver transplantation;
Living donors
- From:
Chinese Journal of Organ Transplantation
2011;32(7):415-418
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the outcomes of living donor liver transplantation (LDLT) for children with biliary atresia (BA) and to summarize the clinical experiences. Methods Forty-four BA patients (26 boys and 18 girls) underwent LDLT between October 2006 and December 2010. Mean (SD) and median (range) age at operation was (12.1 ± 9.0) months and 9 (6-60) months,respectively. The 44 donors were lineal relatives to the consorted recipients. Their mean (SD) and median (range) age at operation was (32. 7 ± 8. 0) months and 31 (20～54) years, respectively. All donor graft types were the left lateral segments with compatible ABO blood groups. Clinical data,including pre-operative evaluations, surgical technique, postoperative management and outcomes in all donors and recipients were retrospectively analyzed. Results All donors were followed up for (17. 5 ± 13. 3) months. No donor mortality was encountered, with a minimal morbidity and no long-term sequelae. Nine out of 44 recipients died. Three patients died of portal vein thrombosis (PVT), one of hepatic artery thrombosis (HAT), two of biliary complications, one of surgical site infections, one of abdominal bleeding and one of pulmonary infection. The overall 1-year and 2-year cumulative survival rate in recipients was 81. 2% and 76. 1 %, respectively. No re-transplantation was done. Postoperative complications included PVT, HAT, biliary leakage and refluxing cholangitis, pulmonary infections,surgical site infections and acute rejection. Conclusion LDLT has been the effective treatment for pediatric recipients with BA and provides favorable prognosis. To improve prognosis of recipients, the key points are pre-operative evaluations, surgical technique, and postoperative management
