Kasahara Mureo, Kaihara Satoshi, Oike Fumitaka, Ito Takashi, Fujimoto Yasuhiro, Ogura Yasuhiro, Ogawa Kohei, Ueda Mikiko, Rela Mohamed, D Heaton Nigel, Tanaka Koichi
Organ Transplant Unit, Kyoto University Hospital, Kyoto, Japan.
Transplantation. 2003 Aug 27;76(4):694-6. doi: 10.1097/01.TP.0000079446.94204.F9.
Living-donor liver transplantation is now an established technique to treat children with end-stage liver disease. Implantation of left-lateral segment grafts can be a problem in small infants because of a large-for-size graft. We report 10 cases of transplantation using monosegment grafts from living donors.
Of 506 children transplanted between June 1990 and June 2002, 10 patients (median age 196 days, median weight 5.9 kg) received monosegment living-donor liver transplants. The indication for using this technique was infants with an estimated graft-to-recipient weight ratio of over 4.0%.
Graft and patient survival was 80.0%. There were no differences in donor operation time and blood loss between monosegmentectomy and left-lateral segmentectomy (n=281). Monosegmental transplantation had a high incidence of vascular complications (20.0%).
Monosegmental living- donor liver transplantation is a feasible option with satisfactory graft survival in small babies with liver failure.
活体供肝肝移植现已成为治疗终末期肝病患儿的一项成熟技术。对于小婴儿而言，由于移植物相对受者过大，植入左外侧叶移植物可能会成为一个问题。我们报告了10例使用活体供者单节段移植物进行移植的病例。
在1990年6月至2002年6月期间接受移植的506例儿童中，10例患者（中位年龄196天，中位体重5.9千克）接受了活体供者单节段肝移植。采用该技术的指征是预计移植物与受者体重比超过4.0%的婴儿。
移植物和患者生存率为80.0%。单节段肝切除术与左外侧叶肝切除术（n = 281）之间，供者手术时间和失血量无差异。单节段移植血管并发症发生率较高（20.0%）。
对于肝功能衰竭的小婴儿，单节段活体供肝移植是一种可行的选择，移植物存活率令人满意。
