Dos Santos José Pedro Fernandes, Martins Ricardo, Lopes Maria Francelina
University of Coimbra, Faculty of Medicine, Coimbra, Portugal.
Surgery Department, Centro Hospitalar e Universitario de Coimbra EPE (CHUC), Coimbra, Portugal.
Pediatr Gastroenterol Hepatol Nutr. 2021 Nov;24(6):528-534. doi: 10.5223/pghn.2021.24.6.528. Epub 2021 Nov 5.
Living-donor liver transplant emerged as an alternative treatment for end stage liver disease due to the lack of cadaveric organs availability that met the demand. In Portugal, pediatric living-donor liver transplant (P-LDLT) was initiated in 2001 in Portugal in order to compensate for the scarcity of cadaveric organs for such cases. The aim of this study was to retrospectively analyze the morbi-mortality of the 28 donors included in P-LDLT program performed at Coimbra's Pediatric Hospital (CHUC), a Portuguese reference center.
We retrospectively collected pertinent donor data and stratified complications according to Clavien's scoring system.
In total, 28.6% (n=8) of the donors had surgical complications. According to Clavien-Dindo's classification, two donors had major complications (Clavien grade ≥3), four donors had grade 2 complications, and two donors had grade 1 complications. There were no P-LDLT-related mortalities in the present case series. The most common verified complications were biliary tract injuries and superficial incisional infections, which are consistent with the complications reported in worldwide series.
These patients from CHUC shows that donor hepatectomy in P-LDLT is a safe procedure, with low morbidity and without mortality.
由于可用于满足需求的尸体器官匮乏，活体供肝移植成为终末期肝病的一种替代治疗方法。在葡萄牙，为弥补此类病例尸体器官的短缺，2001年在葡萄牙启动了儿童活体供肝移植（P-LDLT）。本研究的目的是回顾性分析在葡萄牙的一个参考中心——科英布拉儿童医院（CHUC）进行的P-LDLT项目中纳入的28例供体的发病和死亡情况。
我们回顾性收集了相关的供体数据，并根据Clavien评分系统对并发症进行分层。
总共28.6%（n = 8）的供体出现手术并发症。根据Clavien-Dindo分类，两名供体出现严重并发症（Clavien分级≥3），四名供体出现2级并发症，两名供体出现1级并发症。在本病例系列中没有与P-LDLT相关的死亡。最常见的确诊并发症是胆道损伤和表浅切口感染，这与全球系列报道的并发症一致。
来自CHUC的这些患者表明，P-LDLT中的供体肝切除术是一种安全的手术，发病率低且无死亡病例。
