Department of Surgery, National Medical Research Center of Transplantology and Artificial Organs named after academician V.I. Shumakov, Moscow, Russia.
Department of Transplantology and Artificial Organs, Sechenov First Moscow State Medical University, Moscow, Russia.
Am J Transplant. 2019 Jun;19(6):1847-1851. doi: 10.1111/ajt.15318. Epub 2019 Mar 12.
With the presence of organ shortage, living donors remain important sources of grafts, especially for pediatric recipients. Laparoscopic nephrectomy has become the gold standard for living donors. Additionally, laparoscopic partial liver procurement in living donors has proven its safety and feasibility in the latest studies. We have combined both approaches to perform a simultaneous liver-kidney transplantation in a pediatric patient from the same living donor. Our experience of laparoscopic left lateral sectionectomy and laparoscopic nephrectomy in living donors was the basis for adapting to this procedure. A 29-year-old mother was an ABO-incompatible (ABOi) donor for the left lateral section (LLS) of the liver and left kidney for her 2-year-old son. The postoperative period was uneventful. Two sessions of plasmapheresis and rituximab induction were necessary to prepare for ABOi transplantation. The donor and recipient were discharged on postoperative days 5 and 28, respectively. Simultaneous laparoscopic left lateral sectionectomy and nephrectomy in the same living donor is feasible for transplantation from the parent to the child with advanced laparoscopic expertise.
在器官短缺的情况下，活体供者仍然是移植物的重要来源，特别是对于儿科受者。腹腔镜肾切除术已成为活体供者的金标准。此外，在最近的研究中，腹腔镜活体供者部分肝切除术已证明其安全性和可行性。我们结合这两种方法，为一名来自同一活体供者的儿科患者同时进行了肝-肾移植。我们在活体供者中进行腹腔镜左外叶切除术和腹腔镜肾切除术的经验为适应这一手术提供了基础。一位 29 岁的母亲是她 2 岁儿子的左外侧段（LLS）肝脏和左肾的 ABO 不相容（ABOi）供者。术后恢复顺利。为了准备 ABOi 移植，需要进行两次血浆置换和利妥昔单抗诱导。供者和受者分别于术后第 5 天和第 28 天出院。具有先进腹腔镜专业知识的父母向孩子进行同时腹腔镜左外叶切除术和活体供者肾切除术是可行的。
