Clinical research of deceased-donor split liver transplantation in pediatric recipients / 中华器官移植杂志

ABSTRACT

Objective The use of split liver transplantation (SLT) from deceased donors in children is gradual increasing.This study analyzed the outcomes of SLT in pediatric recipients at a single center in China.Methods From July 2017 to September 2018,42 SLTs in 41 pediatric recipients were performed.There were 24 adult donors with age ranged from 19 to 52 years and 10 pediatric donors with age ranged from 4 years to 16 years.In adult donors,the livers were divided to left lateral segment (LLS) and extended right lobe (ERL) grafts,and 24 LLS and 1 ERL graft were used.Among 10 pediatric donors,the same split technique was used.Further reduction of the grafts was done on 1 ERL and 3 LLS grafts.There were 34 children with biliary atresia,accounting for 82.9％ of the total patients.Twenty-four patients (58.5％) were less than one year old.For pediatric receptor PELD score,5 cases had 0-14 scores,21 cases had 15-29 scores and 16 cases had more than 30 scores.GRWR was 1.65％-4.39％ in children.The cold ischemia time of grafts was 3-13 h.Results The operations were completed successfully in 41 children.During the follow-up period of 2 months to 4 years and 3 months,38 children recovered and discharged.The incidence of complications of hepatic artery,portal vein and biliary tract was 4.8％,7.1％ and 9.5％oo respectively.There were 3 perioperative deaths and 2 recurrent deaths during the follow-up period.The 1-and 2-year survival rates were 90.25％ and 87.8％ respectively,and the graft survival rates were 88.1％ and 85.7％ respectively.Conclusions Under the background of organ donation in China,we should attach importance to the application of splitting technique in pediatric liver transplantation.Grasping the selection criteria of donors and recipients and fine operation can achieve a satisfactory result.