title: Results of living donor liver transplantation in five children with congenital cardiac malformations requiring cardiac surgery.
abstract: In the pediatric population, the concomitant presentation of end-stage liver disease and congenital cardiac malformation occurs rarely. Determining the surgical priority in these cases is a challenge due to the presence of hemodynamic alterations that increase surgical risks. We examined five cases that received living-donor liver transplantation. In four patients that had congenital heart disease with a left to right shunt, two had cardiac surgery first, one had both heart and liver surgery simultaneously, and one underwent liver transplantation first. Both of the patients that received heart surgery before liver transplantation needed emergency liver transplantation because of post-operative liver failure. All five patients had a good outcome. Meticulous surgery, close monitoring, and adequate volume management, in addition to tailoring management decisions to the patient's specific condition, make it possible to correct both the liver and the heart abnormalities with satisfactory results.
authors.affiliation: Department of Transplant Surgery, Kyoto University Hospital, Kyoto, Japan. jpgarbaz@yahoo.com
authors.forename: Jose Pablo
authors.initials: JP
authors.lastname: Garbanzo
authors.forename: Mureo
authors.initials: M
authors.lastname: Kasahara
authors.forename: Hiroto
authors.initials: H
authors.lastname: Egawa
authors.forename: Tadashi
authors.initials: T
authors.lastname: Ikeda
authors.forename: Hiraku
authors.initials: H
authors.lastname: Doi
authors.forename: Seisuke
authors.initials: S
authors.lastname: Sakamoto
authors.forename: Daisuke
authors.initials: D
authors.lastname: Morioka
authors.forename: Edward
authors.initials: E
authors.lastname: Castro
authors.forename: Yasutsugu
authors.initials: Y
authors.lastname: Takada
authors.forename: Koichi
authors.initials: K
authors.lastname: Tanaka
mesh_terms: D006348:Cardiac Surgical Procedures; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications* / Q000601:surgery*; D006801:Humans; D007223:Infant; D008107:Liver Diseases / Q000150:complications* / Q000601:surgery*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male