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01-04-2016 | Original Article

The outcomes of pediatric living donor liver transplantation using small-for-size grafts: experience of a single institute

Authors: Naoya Yamada, Yukihiro Sanada, Yuta Hirata, Noriki Okada, Yoshiyuki Ihara, Hideki Sasanuma, Taizen Urahashi, Yasunaru Sakuma, Yoshikazu Yasuda, Koichi Mizuta

Published in: Pediatric Surgery International | Issue 4/2016

Abstract

Purpose

We aimed to evaluate patients who had undergone pediatric LDLT with small-for-size graft (SFSG) and identify risk factors of graft failure to establish a preoperative graft selection strategy.

Methods

The data was collected retrospectively. SFSG was used in 14LDLTs (5.7 %) of 245 LDLTs performed between May 2001 and March 2014. The mean patient age and body weight at LDLT were 12.6 ± 2.0 years and 40.5 ± 9.9 kg, respectively. The graft type was left lobe in six patients, left + caudate lobe in seven patients, and posterior segment in one patient.

Results

The graft survival rates in SFSG and non-SFSG groups were 78.9 and 93.1 %, respectively (p = 0.045). In the univariate analysis, bleeding volume during LDLT were an independent risk factors for graft failure (p = 0.011). Graft failure was caused by sepsis in all three patients and occurred at a median of 70 postoperative days 70 (range 14–88 days). Among them, two cases showed high preoperative PELD/MELD score (PELD; 19.4 and MELD; 22, respectively).

Conclusions

Pediatric LDLT using SFSG had poor outcome and prognosis, especially when it accompanies the surgical infectious complications with preoperative high PELD/MELD scores.

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Title: The outcomes of pediatric living donor liver transplantation using small-for-size grafts: experience of a single institute
Authors: Naoya Yamada
Yukihiro Sanada
Yuta Hirata
Noriki Okada
Yoshiyuki Ihara
Hideki Sasanuma
Taizen Urahashi
Yasunaru Sakuma
Yoshikazu Yasuda
Koichi Mizuta
Publication date: 01-04-2016
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Surgery International / Issue 4/2016
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-016-3859-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The outcomes of pediatric living donor liver transplantation using small-for-size grafts: experience of a single institute

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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