Liver transplantation for small babies.
Orthotopic liver transplantation remains a major medical and surgical challenge in small pediatric patients. From April 2003 to June 2006, 21 small babies (each of whom weighed less than 10 kg or was younger than 1 year of age) underwent orthotopic liver transplantation. Five were girls and 16 were boys with a mean age of 15.7 +/- 9.3 months (range, 2-24 months); their mean weight at the time of transplantation was 9.8 +/- 3.6 kg (range, 6-16 kg). All transplants were obtained from a living-related donor. Left lateral segment was used for all transplantations. The median graft-to-recipient weight ratio was 3.5% +/- 1.2% (range, 1.5%-6.1%). During the early postoperative period, hepatic arterial thrombosis was identified in 4 patients, and a biliary leak was detected in 2 patients. In 2 patients, portal vein stenosis was identified during the late postoperative period. At the time of this writing, the 17 alive patients (81%) exhibited good graft function at median follow-up of 14.8 +/- 10.9 months (range, 1-39 months). Four patients died during the follow-up. Histological examination revealed hepatocellular carcinoma in 2 patients, and Burkitt's lymphoma in 1 patient. In conclusion, our data confirmed that living-related donors, especially in this age group, provide a reliable source for the organ pool. Satisfactory results can be achieved despite the anatomic handicaps of this age group.
Karakayali
H
H
Department of General Surgery, Başkent University Faculty of Medicine, Ankara, Turkey.
Ozcay
F
F
Sevmis
S
S
Savas
N
N
Haberal
M
M
D000714:Anastomosis, Surgical; D001652:Bile Ducts / Q000601:surgery; D001835:Body Weight; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D007223:Infant; D008099:Liver / Q000033:anatomy & histology; D008107:Liver Diseases / Q000145:classification / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality / Q000502:physiology*; D019520:Living Donors; D008297:Male; D009929:Organ Size; D012189:Retrospective Studies; D016019:Survival Analysis; D020858:Tissue and Organ Harvesting / Q000379:methods; D016896:Treatment Outcome