title: Living donor domino liver transplantation using a maple syrup urine disease donor: A case series of three children - The first report from Japan.
abstract: As the priority of LD-Domino LT is the safety of the first recipient, limitations and technical difficulties in the second recipient often occur. The most technically challenging part of LD-Domino LT is the reconstruction of the vessels. For the reconstruction of HVs, the native HVs were exteriorized as far as possible using a CUSA because longer extensive HVs are essential for facilitating the reconstruction. At the back table, the HVs of the domino graft were sutured together, and the single cuff of the HVs was anastomosed to the IVC by joining the orifices. The HAs, the presence of insufficient length, and multiple vessels in the whole liver rendered the reconstruction more difficult. We determined the dividing sites of the vessels according to the preoperative 3D-CT findings obtained in two institutions. This is the first case series using grafts in DLT obtained from LDLT for patients with MSUD between two institutions. In conclusion, LD-Domino LT is a safe and feasible therapeutic option to expand the donor pool by technical refinement in the reconstruction of the second recipient. Further studies with a greater accumulation of patients and a longer follow-up will be necessary to establish LD-Domino LT using an MSUD donor.
authors: Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan.
authors: Masatoshi
authors: M
authors: Matsunami
authors: Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan.
authors: Akinari
authors: A
authors: Fukuda
authors: Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan.
authors: Kengo
authors: K
authors: Sasaki
authors: Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan.
authors: Hajime
authors: H
authors: Uchida
authors: Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan.
authors: Takanobu
authors: T
authors: Shigeta
authors: Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan.
authors: Yoshihiro
authors: Y
authors: Hirata
authors: Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan.
authors: Hiroyuki
authors: H
authors: Kanazawa
authors: Division of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan.
authors: Reiko
authors: R
authors: Horikawa
authors: Division of Clinical Pathology, National Center for Child Health and Development, Tokyo, Japan.
authors: Atsuko
authors: A
authors: Nakazawa
authors: Department of Pediatric Surgery, Fujita Health University School of Medicine, Aichi, Japan.
authors: Tatsuya
authors: T
authors: Suzuki
authors: Department of Transplant Surgery, Jichi Medical University, Tochigi, Japan.
authors: Koichi
authors: K
authors: Mizuta
authors: Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan.
authors: Mureo
authors: M
authors: Kasahara
mesh_terms: D002675:Child, Preschool; D046148:Donor Selection; D058625:End Stage Liver Disease / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007223:Infant; D007564:Japan; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008375:Maple Syrup Urine Disease; D020858:Tissue and Organ Harvesting / Q000379:methods*
keywords: biliary atresia; domino liver transplantation; familial hypercholesterolemia; maple syrup urine disease; protein C deficiency