[Transplantation of reduced-size livers in children].
Nowadays, liver reduction techniques make it possible to use livers obtained from adults or adolescents for implantation in children. These techniques have been evaluated by analysis of 100 liver transplantations performed between January 1988 and October 1991 in 85 children. Forty-six full-size grafts implanted in 38 children (group 1) were compared with 54 reduced-size grafts implanted in 47 children (group 2). The overall actuarial survival at 4 years was 86 percent. There was no statistical significant difference between the two groups as regards the rates of death (8 versus 19 percent), reoperation (54 versus 64 percent), retransplantation (15 versus 16 percent), hepatic artery thrombosis (13 versus 15 percent) and graft survival (82 versus 70 percent) respectively. Haemorrhage was significantly more frequent in group 1 than in group 2 (P = 0.04), irrespective of whether transplantation was performed urgently or electively. Using reduced-size livers considerably increases the number of liver grafts available to children. Apart from a greater risk of haemorrhage, the results obtained with reduced-size livers were identical with those obtained with full-size livers.
Yandza
T
T
Service de Chirurgie infantile, Hôpital de Bicêtre, Le Kremlin-Bicêtre.
Gauthier
F
F
de Dreuzy
O
O
Lababidi
A
A
Dubousset
A M
AM
Devictor
D
D
Montupet
P
P
Renouard
C
C
Huault
G
G
Valayer
J
J
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004630:Emergencies; D005069:Evaluation Studies as Topic; D006085:Graft Survival; D006801:Humans; D008099:Liver / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D012086:Reoperation; D012092:Replantation
Transplantation des foies réduits chez l'enfant.