Successful liver transplantation for infant with biliary astresia by using liver graft from infant donor after cardiac death
10.3760/cma.j.issn.0254-1785.2012.12.008
- VernacularTitle:心脏死亡幼儿供肝移植治疗幼儿胆道闭锁一例
- Author:
Mingnan ZHANG
;
Xiaoke DAI
;
Chunbao GUO
;
Conglun PU
;
Yingcun LI
;
Quan KANG
;
Zhimei REN
;
Yuhua DENG
;
Qiang XIONG
;
Bolin CHEN
;
Jianyang HU
;
Kai CHEN
- Publication Type:Journal Article
- Keywords:
Infant;
Cardiac death;
Tissue donors;
Liver transplantation
- From:
Chinese Journal of Organ Transplantation
2012;(12):728-731
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the clinical experience of successful liver transplantation from infant donation after cardiac death (DCD) for infant with biliary astresia (BA).Methods The donor was a 16-months-old girl with a body weight of 10 kg,who died of irreversible anoxic cerebral damage after sudden asphyxiation.The recipient was a 24-months-old girl with a body weight of 12 kg,who suffered from icteric concurrent late biliary cirrhosis after the Porta-jejunum anastomosis because of congenital BA.The DCD liver was classically orthotopically transplanted into the infants recipient.The warm ischemia time was 7 min,the cold ischemia time was 360 min,and the graft volume to the standard liver volume (GV/SLV) was 1.02.After operation,the vital signs and transplanted liver function of the recipient were monitored,and the recipient was given treatments of anti-infection,anticoagulation,and improving the microcirculation.The recipient was treated with the triple immunosuppression protocol of tacrolimus,mycophenolate and prednisone to prevent rejection.Results The operating time of the recipient was 480 min,the non-liver stage was 65 min,and the blood loss was 230 mL.The endotracheal intubation was removed from the recipient at 12 h,and the recipient started to eat at 48 h aftcr operation.The recipient had a hepatic artery thrombus on the 3rd and 15th day after operation,and the hepatic artery had re-blood-supply after the hepatic artery catheterization and continuous perfusion with urokinase.The recipient was discharged on the 42nd day,and the recipient was in satisfactory condition to present.Conclusion The infant DCD liver is a better graft for infant liver transplantation for BA.The surgical complications can be reduced with matched volume of donor-recipient liver; and it can guarantee a successful operation with perfect operative technique and careful perioperative management.
