Clinical Evaluation of Hepatic Transection on Pediatric Liver Transplantation

Clinical Evaluation of Hepatic Transection on Pediatric Liver Transplantation

Author Benini, B. B. Autor UNIFESP Google Scholar
Salzedas-Netto, A. A. Autor UNIFESP Google Scholar
Azevedo, R. A. de Autor UNIFESP Google Scholar
Martins, Jose Luiz Autor UNIFESP Google Scholar
Linhares, M. M. Autor UNIFESP Google Scholar
Vicentine, F. P. P. Autor UNIFESP Google Scholar
Gonzalez, A. M. Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Objectives. Liver transplantation is an effective technique in the treatment of end-stage liver disease. the aim of this study was to evaluate the impact of hepatic transection, an advanced surgical technique able to tailor size to generate two grafts to from a single donor.Materials and Methods. A retrospective study between January 2000 and September 2013, reviewing 91 pediatric patients who underwent 96 liver transplants from deceased donors. Patients were distributed into two groups: whole organ (WO, n = 39) and transected liver grafts (TLG, n = 57). the following were evaluated: etiology, anthrophometric parameters (age, weight, height, z score weight/age, and height/age), model for end-stage liver disease (MELD) or pediatric end-stage liver disease (PELD), previous surgeries, transfusion of blood components, 1-year survival rate, preoperative laboratory testing, from the second and seventh postoperative days, lactate during surgery, postoperative complications, duration of surgery, duration of cold and warm ischemia, types of biliary reconstruction, and laboratory testing of the donor.Results. the anthropometric values showed significant differences (P < .05) between the groups. the average age was 124.7 months in the WO group and 33.6 months in the TLG group (P < .0001), while the weight was 28.0 kg and 7.4 kg, respectively (P < .0001). the analysis of z score weight/age showed that the TLG had greater acute and chronic malnutrition, probably due to the etiology of liver disease, present from birth in patients as young. Red blood transfusion was higher in the TLG group (P < .0006) due to the cut surface of the graft, emphasizing the use and improvement of hemostatic techniques.Conclusion. Despite differences between the groups, clinical and surgical complications were similar, showing that liver transection injury didn't change the results of transplantation. There was no impact on liver function, graft, or 1-year patient survival after liver transection. Second postoperative lactate is a predictive factor of death. Transection liver transplantation is an effective method as an alternative to pediatric liver transplantation.
Language English
Date 2014-07-01
Published in Transplantation Proceedings. New York: Elsevier B.V., v. 46, n. 6, p. 1778-1780, 2014.
ISSN 0041-1345 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 1778-1780
Origin http://dx.doi.org/10.1016/j.transproceed.2014.05.046
Access rights Closed access
Type Article
Web of Science ID WOS:000341076800030
URI http://repositorio.unifesp.br/handle/11600/37951

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