title: PEDIATRIC LIVER TRANSPLANTATION WITH EX-SITU LIVER TRANSECTION AND THE APPLICATION OF THE HUMAN FIBRINOGEN AND THROMBIN SPONGE IN THE WOUND AREA.
abstract: Surgical strategy to increase the number of liver transplants in the pediatric population is the ex-situ liver transection (reduction or split). However, it is associated with complications such as hemorrhage and leaks. The human fibrinogen and thrombin sponge is useful for improving hemostasis in liver surgery.
  
  
  
  Compare pediatric liver transplants with ex-situ liver transection (reduction or split) with or without the human fibrinogen and thrombin sponge.
  
  
  
  Was performed a prospective analysis of 21 patients submitted to liver transplantation with ex-situ liver transection with the application of the human fibrinogen and thrombin sponge in the wound area (group A) and retrospective analysis of 59 patients without the sponge (group B).
  
  
  
  The characteristics of recipients and donors were similar. There were fewer reoperations due to bleeding in the wound area in group A (14.2%) compared to group B (41.7%, p=0.029). There was no difference in relation to the biliary leak (group A: 17.6%, group B: 5.1%, p=0.14).
  
  
  
  There was a lower number of reoperations due to bleeding of the wound area of ​​the hepatic graft when the human fibrinogen and thrombin sponge were used.
authors.affiliation: Department of Surgical Gastroenterology and Liver Transplantation.|Postgraduation in Interdisciplinary Surgical Science, Federal University of São Paulo - UNIFESP, São Paulo, SP, Brazil.
authors.forename: Fernando Pompeu Piza
authors.initials: FP
authors.lastname: Vicentine
authors.affiliation: Department of Surgical Gastroenterology and Liver Transplantation.|Postgraduation in Interdisciplinary Surgical Science, Federal University of São Paulo - UNIFESP, São Paulo, SP, Brazil.
authors.forename: Adriano Miziara
authors.initials: AM
authors.lastname: Gonzalez
authors.affiliation: Department of Surgical Gastroenterology and Liver Transplantation.
authors.forename: Ramiro Anthero de
authors.initials: RA
authors.lastname: Azevedo
authors.affiliation: Postgraduation in Interdisciplinary Surgical Science, Federal University of São Paulo - UNIFESP, São Paulo, SP, Brazil.
authors.forename: Barbara Burza
authors.initials: BB
authors.lastname: Benini
authors.affiliation: Department of Surgical Gastroenterology and Liver Transplantation.|Postgraduation in Interdisciplinary Surgical Science, Federal University of São Paulo - UNIFESP, São Paulo, SP, Brazil.
authors.forename: Marcelo Moura
authors.initials: MM
authors.lastname: Linhares
authors.affiliation: Department of Surgical Gastroenterology and Liver Transplantation.|Postgraduation in Interdisciplinary Surgical Science, Federal University of São Paulo - UNIFESP, São Paulo, SP, Brazil.
authors.forename: Gaspar de Jesus
authors.initials: GJ
authors.lastname: Lopes-Filho
authors.affiliation: Department of Surgical Gastroenterology and Liver Transplantation.|Postgraduation in Interdisciplinary Surgical Science, Federal University of São Paulo - UNIFESP, São Paulo, SP, Brazil.
authors.forename: Jose Luiz
authors.initials: JL
authors.lastname: Martins
authors.affiliation: Department of Surgical Gastroenterology and Liver Transplantation.|Postgraduation in Interdisciplinary Surgical Science, Federal University of São Paulo - UNIFESP, São Paulo, SP, Brazil.
authors.forename: Alcides Augusto
authors.initials: AA
authors.lastname: Salzedas-Netto
mesh_terms: D002648:Child; D005340:Fibrinogen / Q000008:administration & dosage*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008099:Liver / Q000601:surgery*; D016031:Liver Transplantation; D011446:Prospective Studies; D012189:Retrospective Studies; D015503:Surgical Sponges; D000072836:Surgical Wound / Q000188:drug therapy*; D013917:Thrombin / Q000008:administration & dosage*
chemical_list: D005340:Fibrinogen; D013917:Thrombin