Domino as a bridge to definitive liver transplantation in a neonate.
An interim liver transplant was used to extend survival in a neonate. This was accomplished by the initial transplant of a left-lateral segment of a metabolically abnormal liver obtained from a 7-yr-old patient with primary oxalosis. This bridging strategy was required because our neonatal patient was dying of fulminant hepatic failure caused by hepatic vein thrombosis and a small liver or liver segment could not be found. Although problems with hyperoxaluria were encountered in the neonate post-transplant, the interim liver transplant enabled the baby to survive and grow until the age of 4 months. At that time, a definitive transplant was performed using the left-lateral segment of his mother's liver. This case represents the first reported use of a pediatric domino transplant where a metabolically abnormal liver was used to allow sufficient growth to permit a definitive liver transplantation.
Casas-Melley
Adela T
AT
Division of Solid Organ Transplantation, Alfred I. duPont Hospital for Children, Wilmington, Delaware 19899, USA.
Thomas
Philip G
PG
Krueger
Leslie J
LJ
Falkenstein
Kathleen P
KP
Flynn
Louise M
LM
Conley
Susan B
SB
Dunn
Stephen P
SP
D002648:Child; D006801:Humans; D006959:Hyperoxaluria / Q000601:surgery; D007223:Infant; D007231:Infant, Newborn; D017093:Liver Failure / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D008297:Male