Liu Hui,Gulimiremu Maimaitijiang,Li Wanfu,et al.Experiences of pro-liver transplantation in children:a report of 11 cases[J].Journal of Clinical Pediatric Surgery,,22():1124-1129.[doi:10.3760/cma.j.cn101785-202306008-006]
Experiences of pro-liver transplantation in children:a report of 11 cases
- Keywords:
- Liver Transplantation/MT; Living Donors/CL; Living Donor Liver Transplantation; Immunosuppression; Treatment Outcome; Child
- Abstract:
- Objective To summarize the clinical efficacies and outcomes of pediatric living donor liver transplantation (LDLT). Methods From September 2021 to February 2023,retrospective analysis was performed for the relevant clinical data of 11 children undergoing LDLT at First Affiliated Hospital of Xinjiang Medical University.Primary diseases included biliary atresia (n=2),portal vein cavernous degeneration (n=2),hepatolenticular degeneration (n=3),tyrosinemia type Ⅰ (n=1),congenital liver fibrosis (n=2) and Budd-Chiari syndrome (n=1).Postoperative interventions included anti-infection,liver protection,bile promotion,anticoagulation and immunosuppression.The immunosuppressive protocols were a triple regimen of tacrolimus,mycophenolate mofetil and methylprednisolone (n=8) and a dual regimen of tacrolimus and methylprednisolone (n=3). Results Mean operative duration was (11.85±1.85) h,mean graft-to-recipient weight ratio (GRWR) (2.20±2.03) %,mean cold ischemic time (75.91±20.87) min,mean warm ischemic time (2.63±2.30) min,mean anhepatic period (60.55±18.86) min and mean intraoperative volume of hemorrhagic loss (770.91±541.12) mL.End-to-end biliary anastomosis (n=4) and bile-intestinal anastomosis (n=7) were performed.There were no vascular or biliary postoperative complications.However,there were thrombocytopenia (n=1),lung infection (n=1),lymphatic leakage (n=2),seizure (n=1) and hypertension with irritability (n=1).All of them were cured and discharged after symptomatic measures.No postoperative complications occurred in donors.Conclusions LDLT is an effective treatment for end-stage liver disease and some genetically metabolic liver diseases in children.Indications for LDLT should be strictly tailored for different primary diseases.And perioperative managements are individualized for optimizing long-term survivals and quality-of-life.
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Memo
收稿日期:2023-6-4。
基金项目:国家自然科学基金面上项目(82170672)
通讯作者:李万富,Email:13699982169@163.com