J Korean Soc Transplant.  2009 Jun;23(1):85-88.

Living Donor Liver Transplantation (LDLT) using Monosegment Graft for a Small Infant

• Suh KS
• Kim T
• Shin WY
• Yi NJ
• Min KW
• Lee KU

Abstract

A 1.5-month-old girl, weighing 4.7 Kg, presented with vomiting, blood tinged stool and jaundice. We performed living donor liver transplantation(LDLT) for the management of fulminant hepatic failure with worsening encephalopathy. The donor was her father, 30 years old, weighing 51 kg. During the pre-operative donor evaluation, a computed tomography volumetry was 170 mL for left lateral section of the liver, which was 3.61% of the graft-recipient weight ratio(GRWR). In donor operation, the reduction of the left lateral section was made just after parenchyma resection of left lateral section was completed, and before clamping of the vessels. The segment II was resected from the left lateral section in situ. The transection plane between segment II and III was identified with the use of intraoperative ultrasonography and clamping of Glisson of segment II. The segment III graft weighed 135 g, which was 2.87 % GRWR. The operation time was 6 hours 15 minutes and transfusion was not needed. Recipient operation was performed in conventional manner of pediatric LDLT using left lateral section with primary closure of abdominal wall without tension. The operation time was 7 hours 35 minutes and cold ischemic time was 1 hour 33 minutes. She recovered well without any significant complications. She discharged on the post operative 24th day. Total bilirubin, aspartic acid transaminase and alanine aminotransferase was 0.6 mg/dL, 26 IU/L and 37 IU/L respectively at the point of discharge. LDLT with monosegment seems to be a feasible option for neonates and small infants requiring liver transplantation.

Keyword

Monosegment; Living donor liver transplantation; Infant

MeSH Terms

Abdominal Wall
Alanine Transaminase
Aspartic Acid
Bilirubin
Cold Ischemia
Constriction
Fathers
Humans
Infant
Infant, Newborn
Jaundice
Liver
Liver Failure, Acute
Liver Transplantation
Living Donors
Tissue Donors
Tolnaftate
Transplants
Vomiting
Alanine Transaminase
Aspartic Acid
Bilirubin
Tolnaftate