Ex vivo reduction of thickness in the left lateral section to tailor the graft size in infantile split deceased donor liver transplantation

Ex vivo reduction of thickness in the left lateral section to tailor the graft size in infantile... AbbreviationsCTLN1citrullinemia type 1CUSACavitron ultrasonic surgical aspiratorGRWRgraft‐to‐recipient weight ratioLDliving donorLDLTliving donor liver transplantationLHVleft hepatic veinLLSleft lateral sectionLTliver transplantationMSGmonosegmental graftTO THE EDITOR:Liver transplantation (LT) in infants and small children is still a challenging operation. One obstacle facing this type of operation is the issue of large‐for‐size grafts because too‐large grafts can result in graft compression, splinting of the diaphragm, and abdominal closure with synthetic mesh, which may lead to other complications. Reduction procedures for adult left lateral section (LLS), including hyper‐reduced grafts and monosegmental grafts (MSGs), have recently been developed to eliminate size mismatch in living donor liver transplantation (LDLT) for small children. However, although both of those grafts are created by removing excess parts of the LLS to achieve a target graft weight, the graft thickness of hyper‐reduced grafts cannot be reduced because this strategy employs a simple nonanatomical reduction of the lateral and/or caudal parts of the LLS. Therefore, MSGs of segment 2 are considered more suitable grafts for small children. Recently, MSGs of segment 2 with the preservation of the main Glisson's pedicle of segment 3 have been increasingly frequently adopted because of the ready accessibility of radiological interventional treatment in the event of biliary and vascular complications. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Liver Transplantation Wiley

Ex vivo reduction of thickness in the left lateral section to tailor the graft size in infantile split deceased donor liver transplantation

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018 by the American Association for the Study of Liver Diseases.
ISSN
1527-6465
eISSN
1527-6473
D.O.I.
10.1002/lt.24976
Publisher site
See Article on Publisher Site

Abstract

AbbreviationsCTLN1citrullinemia type 1CUSACavitron ultrasonic surgical aspiratorGRWRgraft‐to‐recipient weight ratioLDliving donorLDLTliving donor liver transplantationLHVleft hepatic veinLLSleft lateral sectionLTliver transplantationMSGmonosegmental graftTO THE EDITOR:Liver transplantation (LT) in infants and small children is still a challenging operation. One obstacle facing this type of operation is the issue of large‐for‐size grafts because too‐large grafts can result in graft compression, splinting of the diaphragm, and abdominal closure with synthetic mesh, which may lead to other complications. Reduction procedures for adult left lateral section (LLS), including hyper‐reduced grafts and monosegmental grafts (MSGs), have recently been developed to eliminate size mismatch in living donor liver transplantation (LDLT) for small children. However, although both of those grafts are created by removing excess parts of the LLS to achieve a target graft weight, the graft thickness of hyper‐reduced grafts cannot be reduced because this strategy employs a simple nonanatomical reduction of the lateral and/or caudal parts of the LLS. Therefore, MSGs of segment 2 are considered more suitable grafts for small children. Recently, MSGs of segment 2 with the preservation of the main Glisson's pedicle of segment 3 have been increasingly frequently adopted because of the ready accessibility of radiological interventional treatment in the event of biliary and vascular complications.

Journal

Liver TransplantationWiley

Published: Jan 1, 2018

References

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