Pediatric Living Donor Liver Transplantation from Adult Allograft Liver After Resection of Focal Nodular Hyperplasia: The Report Three Cases
Keywords:
Living liver donor, Pediatric liver transplantation, Focal nodular hyperplasiaAbstract
Three pediatric living donor liver transplants were performed at Ramathibodi Hospital in Thailand. The recipients were two children with biliary atresia and one child with neonatal cholestasis jaundice with suspected biliary atresia. All three donors had a single liver lesion, which was suspected to be focal nodular hyperplasia (FNH) on preoperative imaging.
Because no other living donor candidates were available for the recipients, living donor liver transplants were performed. First, a wedge resection of the liver mass was performed. The liver mass was sent for a frozen section intraoperatively to confirm the diagnosis of a benign lesion and to ensure free-margin resection. Then, the transplantation was performed using a standard technique. The liver masses were 1.4-2.3 cm in diameter.
The liver donor hepatectomy was performed simultaneously with the recipient's total hepatectomy. The estimated liver graft volume was 176.5-336.5 cm3. The estimated graft-recipient weight ratio (GRWR) was 1.4-3.7%. The actual graft weight was 168-371 grams, and the actual GRWR was 1.6-3.5%. The liver graft was implanted in the recipient using a standard piggyback technique.
The donor and recipient were discharged after the operation without any complications. Follow-up ultrasound of the upper abdomen at six months showed no disease recurrence.
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