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Adult liver transplantation using pediatric donor livers after cardiac or brain death: A report of three cases

The present study reports on the experience at Jiangxi Provincial People's Hospital (Nanchang, China) with liver transplantation in adults using pediatric donor livers, including indications, technique and results. A total of three cases of liver transplantation performed between April 2008 and...

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Autores principales: Ding, Limin, Deng, Lishan, Li, Xinchang, Xu, Zhidan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: D.A. Spandidos 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7480125/
https://www.ncbi.nlm.nih.gov/pubmed/32952618
http://dx.doi.org/10.3892/etm.2020.9155
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author Ding, Limin
Deng, Lishan
Li, Xinchang
Xu, Zhidan
author_facet Ding, Limin
Deng, Lishan
Li, Xinchang
Xu, Zhidan
author_sort Ding, Limin
collection PubMed
description The present study reports on the experience at Jiangxi Provincial People's Hospital (Nanchang, China) with liver transplantation in adults using pediatric donor livers, including indications, technique and results. A total of three cases of liver transplantation performed between April 2008 and May 2016 were retrospectively reviewed. Liver procurement and trimming, recipient selection, surgical tips, prevention and treatment of small-for-size syndrome, selection of immunosuppressive regimens, prevention and treatment of vascular complications and anticoagulant therapy were discussed. The three pediatric donors were 8, 8 and 10 years old. The three recipients were confirmed to have primary liver cancer. In recipient 1 (female; age, 39 years), jaundice persisted in the recipient after the liver transplantation. A reduced dose of FK506 was then given to gradually decrease the total bilirubin level to the normal range. Recipient 1 recovered and was discharged from hospital; however, the patient died of liver cancer recurrence and bone metastasis 6 years post-transplantation. In recipient 2 (male; age, 56 years), the recipient experienced sudden abdominal distension on postoperative day 7. The patient's clotting time was prolonged and the transaminase level was sharply increased, peaking on day 9. The patient was suspected of having small-for-size syndrome and was treated symptomatically. The patient experienced a significant improvement in symptoms on postoperative day 13 and regular postoperative follow-ups were performed until now and the patient is now in remission. In recipient 3 (male; age, 48 years), the recipient recovered well and the liver function returned to normal on postoperative day 3. The patient was discharged from hospital and has been in remission thus far. Adult liver transplantations from pediatric donors are feasible treatments. Systematic donor and recipient assessments, sound surgical skills and optimal postoperative treatments are essential for success in the transplantation of livers from pediatric donors into adult recipients. Considering the condition of the donor liver, the selection of recipients and appropriate surgical methods are particularly important in these cases.
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spelling pubmed-74801252020-09-17 Adult liver transplantation using pediatric donor livers after cardiac or brain death: A report of three cases Ding, Limin Deng, Lishan Li, Xinchang Xu, Zhidan Exp Ther Med Articles The present study reports on the experience at Jiangxi Provincial People's Hospital (Nanchang, China) with liver transplantation in adults using pediatric donor livers, including indications, technique and results. A total of three cases of liver transplantation performed between April 2008 and May 2016 were retrospectively reviewed. Liver procurement and trimming, recipient selection, surgical tips, prevention and treatment of small-for-size syndrome, selection of immunosuppressive regimens, prevention and treatment of vascular complications and anticoagulant therapy were discussed. The three pediatric donors were 8, 8 and 10 years old. The three recipients were confirmed to have primary liver cancer. In recipient 1 (female; age, 39 years), jaundice persisted in the recipient after the liver transplantation. A reduced dose of FK506 was then given to gradually decrease the total bilirubin level to the normal range. Recipient 1 recovered and was discharged from hospital; however, the patient died of liver cancer recurrence and bone metastasis 6 years post-transplantation. In recipient 2 (male; age, 56 years), the recipient experienced sudden abdominal distension on postoperative day 7. The patient's clotting time was prolonged and the transaminase level was sharply increased, peaking on day 9. The patient was suspected of having small-for-size syndrome and was treated symptomatically. The patient experienced a significant improvement in symptoms on postoperative day 13 and regular postoperative follow-ups were performed until now and the patient is now in remission. In recipient 3 (male; age, 48 years), the recipient recovered well and the liver function returned to normal on postoperative day 3. The patient was discharged from hospital and has been in remission thus far. Adult liver transplantations from pediatric donors are feasible treatments. Systematic donor and recipient assessments, sound surgical skills and optimal postoperative treatments are essential for success in the transplantation of livers from pediatric donors into adult recipients. Considering the condition of the donor liver, the selection of recipients and appropriate surgical methods are particularly important in these cases. D.A. Spandidos 2020-11 2020-08-31 /pmc/articles/PMC7480125/ /pubmed/32952618 http://dx.doi.org/10.3892/etm.2020.9155 Text en Copyright: © Ding et al. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (https://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
spellingShingle Articles
Ding, Limin
Deng, Lishan
Li, Xinchang
Xu, Zhidan
Adult liver transplantation using pediatric donor livers after cardiac or brain death: A report of three cases
title Adult liver transplantation using pediatric donor livers after cardiac or brain death: A report of three cases
title_full Adult liver transplantation using pediatric donor livers after cardiac or brain death: A report of three cases
title_fullStr Adult liver transplantation using pediatric donor livers after cardiac or brain death: A report of three cases
title_full_unstemmed Adult liver transplantation using pediatric donor livers after cardiac or brain death: A report of three cases
title_short Adult liver transplantation using pediatric donor livers after cardiac or brain death: A report of three cases
title_sort adult liver transplantation using pediatric donor livers after cardiac or brain death: a report of three cases
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7480125/
https://www.ncbi.nlm.nih.gov/pubmed/32952618
http://dx.doi.org/10.3892/etm.2020.9155
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