Hepatic artery reconstruction in pediatric living donor liver transplantation under 10 kg, without microscope use.
Arterial reconstructions are pivotal, particularly in pediatric LDLT. We describe microsurgical reconstruction technique with 6x loupes and the clinical course of the first 23 less than 10 kg recipients in an initial LDLT program at a developing country. From March 2002 to October 2008, 286 liver transplantation were performed in 279 patients at our unit. There were 73 children and 206 adults. Among the children, 23 weighing less than 10 kg were recipients from living donors. Arterial reconstructions were with end-to-end interrupted suture using a 6x magnification loupe, according to the untied suture technique. All patients were prospectively followed by color Doppler ultrasound protocol. In our initial experience there were no arterial complications. With mean 24 months of follow-up, 19 patients (82%) are alive with good graft function. Hepatic artery in LDLT can be safely reconstructed with microsurgical techniques without microscope using, with 6x loupe magnification, and can achieve good results in patients under 10 kg.
Enne
Marcelo
M
Hepatobiliary Surgery, Liver Transplantation Unit, Hospital Geral de Bonsucesso, Ministério da Saúde, Rio de Janeiro, Brazil. marceloenne@gmail.com
Pacheco-Moreira
Lucio
L
Balbi
Elizabeth
E
Cerqueira
Alexandre
A
Alves
Jefferson
J
Valladares
Marcia Angélica
MA
Santalucia
Giuseppe
G
Martinho
Jose-Manoel
JM
D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D001835:Body Weight; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007223:Infant; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008853:Microscopy; D008866:Microsurgery / Q000379:methods*; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D014656:Vascular Surgical Procedures / Q000379:methods*