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- Title
Successful living donor liver transplantation plus domino-auxiliary partial orthotopic liver transplantation for pediatric patients with metabolic disorders.
- Authors
Dong, Chong; Song, Zhuolun; Meng, Xingchu; Sun, Chao; Wang, Kai; Yang, Yang; Qin, Hong; Han, Chao; Zhang, Fubo; Zheng, Weiping; Gao, Wei
- Abstract
Purpose: To investigate the efficacy of living donor liver transplantation (LDLT) plus domino-auxiliary partial orthotopic liver transplantation (D-APOLT) in pediatric patients with metabolic disorders. Methods: From May 2017 to October 2018, two patients with ornithine aminotransferase deficiency (OTCD) and one patient with type I Crigler-Najjar syndrome (CNS1) received LDLT, their livers were prepared as donors for D-APOLT. Two patients with CNS1 received domino liver grafts from OTCD patients; one OTCD patient received a domino liver graft from a CNS1 patient. Results: The mean follow-up was 26.6 months. The liver function and ammonia remained in the normal range at the end of the follow-up in all recipients. One D-APOLT patient experienced portal vein thrombosis 2 days after transplantation and required reoperation, this patient presented an imbalance of portal blood perfusion between the native and the domino liver at 8 months after liver transplant. The imbalance was improved by interventional radiology treatment. Two LDLT patients experienced early mild acute rejection. Conclusions: The non-cirrhotic livers from pediatric patients with metabolic liver disease can be used as domino donor grafts for selected pediatric patients with different metabolic liver disease. D-APOLT achieves ideal recipient outcomes and provides a strategy to expand donor source for children.
- Subjects
CHILD patients; LIVER transplantation; PORTAL vein diseases; METABOLIC disorders; PORTAL vein; INTERVENTIONAL radiology; PORTAL vein surgery
- Publication
Pediatric Surgery International, 2020, Vol 36, Issue 12, p1443
- ISSN
0179-0358
- Publication type
Article
- DOI
10.1007/s00383-020-04756-3