Impact of Liver Ex Situ Transection on Pediatric Liver Transplantation

Impact of Liver Ex Situ Transection on Pediatric Liver Transplantation

Autor Salzedas-Netto, A. A. Autor UNIFESP Google Scholar
Amadei, H. L. Autor UNIFESP Google Scholar
Castro, C. C. L. Autor UNIFESP Google Scholar
Mattar, R. H. Autor UNIFESP Google Scholar
Medeiros, K. L. Autor UNIFESP Google Scholar
Linhares, M. M. Autor UNIFESP Google Scholar
Duarte, A. A. B. Autor UNIFESP Google Scholar
Chinen, E. S. Autor UNIFESP Google Scholar
Marino, G. C. Autor UNIFESP Google Scholar
Matos, C. A. Autor UNIFESP Google Scholar
Lopes-Filho, G. Autor UNIFESP Google Scholar
Martins, Jose Luiz Autor UNIFESP Google Scholar
Gonzalez, A. M. Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo Ex situ hepatic transection (ESHT) has allowed transplantation of younger and smaller patients than whole liver grafts. Liver transection is a technical challenge due to the prolonged back table time, possible graft lesions, and increased surgical bleeding from the cut surface. We compare the outcomes of whole versus transected liver grafts in pediatric liver transplantation.Methods. We retrospectively studied 41 pediatric patients who underwent 42 consecutive liver transplants (1 retransplant) from cadaveric donors. the study included all patients <18 years old who were transplanted at our institution from December 2001 to September 2009. Patients were distributed into 2 groups: whole organ (WO; n = 20) and transected liver grafts (TLG; n = 21). the ESHT grafts included 17 splits and 5 reduced size livers. We evaluated the age, weight, blood component transfusions, 1-year survival, laboratory tests at 2nd and 7th days postoperatively, surgical complications, reoperations, rejection episodes, cold ischemia time, biliary reconstruction type, and donor laboratory tests. Data were analyzed using Fisher and Student's t-tests.Results. the mean age was 115 months (range, 7 months to 17.6 years) in the WO group and 43.3 months (range, 5 months to 16.25 years) in the TLG group (P = .0003). Mean weight was 19.8 kg (range, 5.8-67) and 9.7 Kg (range, 5.2-57) in the WO and TLG groups, respectively (P = .0079). Red blood cell transfusion was higher in the TLG group (P = .0479). Laboratory tests showed no difference between the 2 groups considering hepatic lesions or function markers. One-year patient survivals were 90% and 85.8% among the WO and LTG, respectively (P = .588). the overall 1-year survival rate was 88.8%.Conclusion. ESHT allowed smaller and younger children to be transplanted. There was an increased necessity of red blood cell transfusions after hepatic transection. There was no impact on liver function or 1-year patient or graft survival after ESHT.
Idioma Inglês
Data 2010-03-01
Publicado em Transplantation Proceedings. New York: Elsevier B.V., v. 42, n. 2, p. 507-510, 2010.
ISSN 0041-1345 (Sherpa/Romeo, fator de impacto)
Editor Elsevier B.V.
Extensão 507-510
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000276051400029

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