Ann Liver Transplant.  2023 May;3(1):50-56. 10.52604/alt.23.0001.

Living donor liver transplantation with hyperreduced segment II monosegment graft for an infant weighing 3 kilograms

• Namgoong JM
• Park GC
• Hwang S
• Kim SH
• Ha S
• Kim KM
• Oh SH

• KMID: 2560922
• DOI: http://doi.org/10.52604/alt.23.0001

Abstract

In liver transplantation for small infants, graft-size matching to the recipient’s abdomen is the most important factor for successful transplantation. We herein present the surgical technique and clinical outcome of pediatric living donor liver transplantation (LDLT) using a hyperreduced segment II monosegment (HRS2MS) graft in an infant weighing 3 kilograms (kg). A female patient was prematurely born at 28 weeks 5 days with a body weight of 1,030 g. At 4 months after birth, LDLT was performed due to progression of liver failure with deterioration of the general condition and vital signs at the patient body weight of 3.0 kg. Considering that her height was 49 cm at transplantation, her ideal body weight was estimated to be only 2.1 kg. The living donor was a 33-year-old mother of the patient. A HRS2MS graft of 123 g was recovered, which was equivalent to a graft-to-recipient weight ratio of 4.1%. The standard surgical procedures for pediatric LDLT were performed. Because the recipient’s native liver was enlarged and weighed 336 g and there was massive ascites, primary closure of the abdomen was successfully performed. Follow-up computed tomography studies showed uneventful graft implantation. Currently, she has been doing well for more than three months after transplantation. In conclusion, pediatric LDLT using a HRS2MS graft can be a useful option for treating a very small infant although large-for-size graft-related issues still remain to be solved.

Keyword

Infant; Large-for-size graft; Monosegment graft; Graft-to-recipient weight ratio; Size reduction