[Living-related liver transplantation--first experiences at Rabin Medical Center].
Our experience with living-related liver transplantation is described. In 2 boys and 1 girl, aged 4-4.5 years with acute, fulminating hepatitis A, the presence of very severe jaundice (bilirubin levels > 18 mg%) associated with severe coagulopathy (INR > 10) and encephalopathy indicated the need for urgent liver transplantation. In all 3 cases the left lateral hepatic segment of a matched blood type parent was transplanted. None of the donors suffered a serious complication postoperatively and all returned to full activity in 6-16 weeks. The post-transplantation course was uneventful in 1 child, but in the other 2 there was hepatic arterial thrombosis in 1 at 1 day and in the other at 8 days post-transplantation. Early detection of arterial thrombosis by Doppler sonography permitted salvage of the 2 hepatic grafts after thrombectomy and re-anastomosis. In 1 of these 2 children an anastomotic biliary stricture was found 2 months after transplantation. It was corrected at surgery and a percutaneous stent was inserted. All 3 children are alive with normal graft function at 2, 7 and 8 months post-transplantation, respectively. This initial experience indicates that living-related liver transplantation is feasible in Israel. The technique might help to solve our severe organ shortage for children awaiting liver transplantation.
Bar-Nathan
N
N
Dept. of Transplantation, Rabin Medical Center, Petah Tikva.
Shapira
Z
Z
Shaharabani
E
E
Yussim
A
A
Ben-Ari
Y
Y
Sheinfeld
T
T
Zehavi
I
I
Shapira
R
R
Dinari
G
G
Ben-Ari
Z
Z
Tur-Kaspa
R
R
Mor
E
E
D000328:Adult; D002675:Child, Preschool; D005260:Female; D006498:Hepatectomy; D006501:Hepatic Encephalopathy / Q000601:surgery; D006506:Hepatitis A / Q000601:surgery; D006801:Humans; D019520:Living Donors; D008297:Male; D010290:Parents; D011183:Postoperative Complications