잠시만 기다려 주세요. 로딩중입니다.

Pediatric split liver transplantation using a hyperreduced left lateral segment graft in an infant weighing 4 kg

대한이식학회지 2020년 34권 3호 p.204 ~ 209
Namgoong Jung-Man, 황신, 김대연, 송기원, 안철수, 김경모, 오석희,
소속 상세정보
 ( Namgoong Jung-Man ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
황신 ( Hwang Shin ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
김대연 ( Kim Dae-Yeon ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
송기원 ( Song Gi-Won ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
안철수 ( Ahn Chul-Soo ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
김경모 ( Kim Kyung-Mo ) - University of Ulsan College of Medicine Asan Medical Center Department of Pediatrics
오석희 ( Oh Seak-Hee ) - University of Ulsan College of Medicine Asan Medical Center Department of Pediatrics

Abstract


We present a case of successful split liver transplantation (LT) using a hyperreduced left lateral segment (LLS) graft in a 106-day-old female infant patient weighing 4 kg. The patient was diagnosed with progressive familial intrahepatic cholestasis. Her general condition and liver function deteriorated progressively and she was finally allocated for a split LT under status 1. The deceased donor was a 20-year-old female weighing 63.7 kg. We performed in situ liver splitting and in situ size reduction sequentially. The weight of the hyperreduced LLS graft was 225 g, with a graft-recipient weight ratio of 5.5%. We performed recipient hepatectomy and graft implantation according to the standard procedures for pediatric living-donor LT. Since the graft was too large for primary abdomen closure, the abdominal wall was closed in three stages to make a prosthetic silo, temporary closure with a xenograft sheet, and final primary repair over 2 weeks. The patient has been doing well for more than 6 years after transplantation. In conclusion, split LT using a hyperreduced LLS graft can be a useful option for treating small infants. However, large-for-size graft-related problems, particularly in terms of graft thickness, still remain to be solved.

키워드

Infant, Large-for-size graft; Pediatric transplantation; Graft-recipient weight ratio; Left lateral segment

원문 및 링크아웃 정보

등재저널 정보