Borenstein Steven, Diamond Ivan R, Grant David R, Greig Paul D, Jones Nicola, Ng Vicky, Roberts Eve, Fecteau Annie
Pediatric Academic Multi-Organ Transplant Program, The Hospital for Sick Children, The University of Toronto, Toronto, Ontario, Canada.
J Pediatr Surg. 2003 May;38(5):668-71. doi: 10.1016/jpsu.2003.50179.
BACKGROUND/PURPOSE: Live-donor liver transplantation (LDLT) has developed to address the critical shortage of cadaveric organs that accounts for 20% of children who die while awaiting for a liver transplant in Ontario each year. This report reviews the outcome of the pediatric recipients of LDLT at the authors' center.
The charts of all children who received a LDLT between June 1996 and March 2002 were reviewed retrospectively.
Thirteen children (mean age, 3.6 years) underwent LDLT. All donors were parents except for one cousin. Ten grafts were left-lateral segments, 2 were right lobes, and 1 was a left lobe. Three patients required a SILASTIC((R)) (Dow Corning, Midland, MI) patch for delayed abdominal wall closure. Patient and graft survival rate was 100% with a median follow-up of 376 days. Major postoperative complications included biliary leaks (n = 2), biliary strictures (n = 1), portal vein thrombosis (n = 1), and hepatic venous complications (n = 1). There were no cases of hepatic artery thrombosis. Ten of 12 children became Positive for Epstein-Barr virus (EBV), and 3 of these patients had readily treatable post-transplant lymphoproliferative disorder.
LDLT is an acceptable alternative to cadaveric transplantation for children with end-stage liver disease.
背景/目的：活体供肝肝移植（LDLT）的发展是为了解决尸体器官严重短缺的问题，在安大略省，每年有20%的儿童在等待肝移植的过程中死亡。本报告回顾了作者所在中心小儿LDLT受者的治疗结果。
对1996年6月至2002年3月期间接受LDLT的所有儿童的病历进行回顾性分析。
13名儿童（平均年龄3.6岁）接受了LDLT。除一名表亲外，所有供者均为父母。10例移植的是左外侧叶，2例是右叶，1例是左叶。3例患者需要使用SILASTIC（陶氏化学公司，美国密歇根州米德兰）补片延迟关闭腹壁。患者和移植物存活率为100%，中位随访时间为376天。术后主要并发症包括胆漏（n = 2）、胆管狭窄（n = 1）、门静脉血栓形成（n = 1）和肝静脉并发症（n = 1）。无肝动脉血栓形成病例。12名儿童中有10名EB病毒（EBV）检测呈阳性，其中3例患者患有易于治疗的移植后淋巴细胞增生性疾病。
对于终末期肝病儿童，LDLT是尸体肝移植可接受的替代方案。
