In-situ split liver transplantation for pediatric recipient: a single-center experience

Abstract

Objective To evaluate the efficacy of in-situ split liver transplantation (ISSLT) in children. Methods From June 2015 to August 2018, 10 liver grafts from DBD were split in-situ. All the donors were male, and the median age of the donors was 28.5 year old (18-48 year). One left half graft and 9 left lateral lobe grafts (including 2 reduced size grafts) were transplanted to 10 pediatric recipients. Four grafts were transplanted in our center, and the rest 6 grafts were shared to other two transplant center. The primary diseases of the recipients included biliary atresia (8/10), hepatic sinus obstruction syndrome (1/10) and Alagille syndrome (1/10). The median age of the recipients was 10 month (7 month-11 year), and the mean body weight was 9.8±6.6 kg (5-28 kg). Results All liver grafts were split in-situ. The mean split time of liver grafts was 88.5±18.9 min. The mean weight of split grafts was 336.7±85.4 g. All recipients were subjected to piggyback liver transplantation. Operation time was 542.5±112.1 min. Anhepatic time was 52.0±13.5 min. GRWR was (3.98±0.96)%. GRWR of two cases was more than 5%, so segment Ⅲ was partially reduced. During the follow-up period, 9 cases were alive and 1 case died due to multiple organ failure 1 day after liver transplantation. Conclusions ISSLT can enlarge the graft pool for children and achieve good results. Key words: Liver transplantation; In-situ split; Child