Ann Liver Transplant.  2022 Nov;2(2):121-126. 10.52604/alt.22.0022.

Pediatric liver transplantation using hyper-reduced left lateral section and monosegment graft for infant patients: A collective review of Korean experience

• Park CS
• Chung YK

• KMID: 2560906
• DOI: http://doi.org/10.52604/alt.22.0022

Abstract

During liver transplantation (LT) in pediatric patients, graft size matching to the recipient’s abdomen is of critical importance. In order for the left lateral section (LLS) graft to be as small as possible, the LLS has to be reduced to be a monosegment or hyper-reduced LLS (HRLLS) graft. The demand for LT in small infants has been persistently present, but the number of LT using monosegment or HRLLS grafts is very limited in Korea. Therefore, this study investigates pediatric LT using HRLLS or monosegment grafts to delineate its characteristics in Korea. The average age and body weight of the patients were 4.0±1.7 months and 5.3±1.4 kg, respectively, for three cases of pediatric LT with HRLLS graft. The mean weight of the HRLLS grafts was 191.7±62.1 g and the graft-recipient weight ratio was 3.75%±1.57%. All patients recovered from their respective LT operation and are actually in good health, more than 6 years after the LT. There was one case of pediatric deceased donor LT with in situ size reduction of recipient-graft size. Another case presented dextroplantation of a reduced LLS graft. A case of pediatric living donor LT using a monosegment graft procured by pure 3-dimensional laparoscopic LLS resection and in situ reduction was also reported. In conclusion, making a HRLLS or monosegment graft during living donor LT and split LT can be a useful option for treating pediatric patients.

Keyword

Deceased donor; Liver transplantation; Pediatric recipient; Left lateral section graft; Monosegment