title: Negative wound therapy to manage large-for-size liver graft mismatch.
abstract: Liver volume matching in liver transplantation (LT) is of paramount importance. There is no agreement for its definition, ranging from a graft-to-recipient-weight-ratio greater than 4% in paediatric to less than 2.5% in adult LT. Advances have been obtained to avoid small for size grafts, but management of large grafts remains a major challenge in this setting. Consequences include difficult anastomosis, poor vascular alignment, difficult wound closure, graft compression and necrosis. We report on two patients who underwent LT with large grafts and develop major liver graft injury. Technical solutions used in these two cases are presented and discussed. Negative wound therapy allowed a rapid closure of abdominal wall and salvage of the graft.
authors.affiliation: Department of Hepatobiliary and Liver Transplantation Surgery, hôpital Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Université Pierre-et-Marie-Curie, Paris, France.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Brustia
authors.affiliation: Department of Hepatobiliary and Liver Transplantation Surgery, hôpital Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: Fabiano
authors.initials: F
authors.lastname: Perdigao
authors.affiliation: Department of Hepatobiliary and Liver Transplantation Surgery, hôpital Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Department of Hepatobiliary surgery and Liver Transplantation, Hôpital Beaujon - Assistance publique-Hôpitaux de Paris, 100, boulevard du Général-Leclerc, 92118 Clichy, France.
authors.forename: Ailton
authors.initials: A
authors.lastname: Sepulveda
authors.affiliation: Department of Hepatobiliary and Liver Transplantation Surgery, hôpital Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: Astrid
authors.initials: A
authors.lastname: Schielke
authors.affiliation: Department of Hepatobiliary and Liver Transplantation Surgery, hôpital Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Université Pierre-et-Marie-Curie, Paris, France.
authors.forename: Filomena
authors.initials: F
authors.lastname: Conti
authors.affiliation: Department of Hepatobiliary and Liver Transplantation Surgery, hôpital Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Université Pierre-et-Marie-Curie, Paris, France. Electronic address: olivier.scatton@gmail.com.
authors.forename: Olivier
authors.initials: O
authors.lastname: Scatton
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000328:Adult; D001830:Body Surface Area; D015209:Cholangitis, Sclerosing / Q000601:surgery; D005260:Female; D006085:Graft Survival; D006509:Hepatitis B / Q000601:surgery; D006801:Humans; D016031:Liver Transplantation / Q000379:methods; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods; D009929:Organ Size; D016896:Treatment Outcome; D014945:Wound Healing