Application of small-for-size graft of pediatric donor liver transplantation in an adult recipient with acute liver failure: a report of one case and literature review
10.3969/j.issn.1674-7445.2018.03.011
- VernacularTitle:儿童小体积供肝肝移植治疗成人急性肝衰竭1例附文献复习
- Author:
Zhenghui YE
1
;
Hongchuan ZHAO
;
Fan HUANG
;
Guobin WANG
;
Xiaojun YU
;
Liujin HOU
Author Information
1. 安徽医科大学第一附属医院普外科暨器官移植中心
- Keywords:
Liver transplantation;
Small-for-size;
Pediatric donor liver;
Acute liver failure;
Graft-to-recipient weight ratio;
Small-for-size liver syndrome;
Pleural effusion;
Liver regeneration;
Pulmonary infection;
Fungal infection;
Abdominal infection
- From:
Organ Transplantation
2018;9(3):227-231
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the clinical experience of small-for-size graft of pediatric donor liver transplantation in the treatment of acute liver failure in an adult recipient. Methods Clinical data of application of small-for-size graft of pediatric donor liver transplantation in an adult recipient was retrospectively analyzed and literature review was performed. Results The pediatric donor was aged 4.5 years old and the weight of donor liver from donation after brain death was 544.6 g. The body mass of recipient was 52 kg. The graft-to-recipient weight ratio was 1.05%. The classic orthotopic liver transplantation was performed. Postoperative recovery was not satisfying. The recipient suffered from brain edema, stress gastrointestinal bleeding, acute kidney injury, small-for-size liver syndrome, atelectasis, lung infection, fungal infection, abdominal infection, pleural effusion and other postoperative complications. After symptomatic and comprehensive treatment, the function of liver graft was gradually restored and regenerated to the normal size of adult liver at postoperative 2 to 3 weeks. The patient was discharged after 102 d hospitalization. During the follow-up at postoperative 10 months, the liver function was evaluated normal and the quality of life was favorable. Conclusions Pediatric small-for-size donor livers can be successfully transplanted to the adult recipients. Nevertheless, it is necessary to select the appropriate recipients, surgical methods and fine perioperative management according to the conditions of the donor livers.
