Living-donor liver Xplantation with monosegments

nighthawk

Transplantation 2003; 76(4):694-696

Living-donor liver transplantation with monosegments

Mureo Kasahara 1 4; Satoshi Kaihara 1; Fumitaka Oike 2; Takashi Ito 2;
Yasuhiro Fujimoto 2; Yasuhiro Ogura 2; Kohei Ogawa 2; Mikiko Ueda 2; Mohamed
Rela 3; Nigel D Heaton 3; Koichi Tanaka 1 2

Background.
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.

Method.
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%.

Results.
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%).

Conclusion.
Monosegmental living- donor liver transplantation is a feasible option with
satisfactory graft survival in small babies with liver failure.

This work was supported in part by grants from the Scientific Research Fund
of the Ministry of Education and by a Research Grant for Immunology, Allergy
and Organ Transplant from the Ministry of Health and Welfare, Japan.

1 Organ Transplant Unit, Kyoto University Hospital, Kyoto, Japan.
2 Department of Transplantation and Immunology, Kyoto University Faculty of
Medicine, Kyoto, Japan.
3 Liver Transplant Surgical Service, King's College Hospital, Denmark Hill,
London, United Kingdom.
4 Address correspondence to: Dr. Mureo Kasahara, Department of Transplant
Surgery, Kyoto University Hospital, 54 Kawara-cho, Shogoin, Sakyo-ku, Kyoto
606-8507, Japan. E-mail: [email protected].
Received 25 November 2002.
Accepted 23 April 2003.