Temporary wound closure with expanded polytetrafluoroethylene in pediatric liver transplantation.
A shortage of donor organs of appropriate size causes lengthy delays for many children awaiting liver transplantation, and results in the death of some children on the active waiting list.  A major contribution to overcoming this problem has been the use of reduced livers from adult donors.  However, reduced adult livers are frequently too large to be used for small pediatric recipients ( less than 8 kg) because of the serious problems which occur when too tight an abdominal closure is attempted.  We report a technique which we have used successfully in 2 children, involving the insertion of a temporary patch graft of expanded polytetrafluoroethylene.  This allowed comfortable abdominal wound closure, which would not otherwise have been possible.  Delayed primary closure of the abdomen 4-5 days later was achieved without difficulty in each case, the liver grafts having decreased markedly in size by this time.  The technique allows greater flexibility in the use of donor livers for pediatric recipients, and thus has the potential to reduce waiting times and deaths on the waiting list for small children requiring liver transplantation.
Shun
A
A
Australian National Liver Transplantation Unit, Royal Prince Alfred Hospital, Camperdown, N.S.W., Australia.
Thompson
J F
JF
Dorney
S F
SF
Sheil
A G
AG
D001656:Biliary Atresia / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D011138:Polytetrafluoroethylene / Q000627:therapeutic use; D013526:Surgical Mesh; D013536:Suture Techniques