Liver transplantation, including the concept of reduced-size liver transplants in children

• Published in: Annals of surgery 1988-10, Vol.208 (4), p.410-420
• Main Authors: BROELSCH, C. E, EMOND, J. C, THISTLETHWAITE, J. R, WHITINGTON, F. F, ZUCKER, A. R, BAKER, A. L, ARAN, P. F, ROUCH, D. A, LICHTOR, J. L
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Child; Child, Preschool; Humans; Infant; Liver Transplantation; Liver, biliary tract, pancreas, portal circulation, spleen; Medical sciences; Middle Aged; Postoperative Complications; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Tissue Donors; Transplantation, Homologous - methods; Transplantation, Homologous - mortality
• ISSN: 0003-4932; 1528-1140
• DOI: 10.1097/00000658-198810000-00003

Since the establishment of a clinical program in liver transplantation in 1984, 162 liver transplants have been performed in 131 patients (78 adults, 53 children). The patient mortality rate while waiting for a suitable organ has been 8% for adults and only 4% for children (25-46% reported in the literature). The low pediatric mortality is a result of the use of reduced-size liver transplants. A total of 14 procedures have been performed in recipients whose clinical condition was deteriorating and for whom no full-size graft could be located. Of 14 children, 13 were less than 3 years of age. Patient survival is 50%, comparable to survival of high-risk recipients of full-size livers. Using reduced-size liver grafting in a transplant program can lower mortality for children awaiting a transplant by overcoming size disparity. Reduced-size liver grafting will allow more effective use of donor resources and provide a potential avenue of research for organ splitting and living related donation.