journal article

Journal Article

Pediatric Transplantation. 2014, 18(6)

A case of pediatric live-donor liver transplantation with a left lateral segment reduction by a linear stapler after reperfusion

John Wiley and Sons Inc

English

2014-08-13

https://doi.org/10.1111/petr.12307

This is the peer reviewed version of the following article: Zenitani M., Ueno T., Nara K., et al. A case of pediatric live-donor liver transplantation with a left lateral segment reduction by a linear stapler after reperfusion. Pediatric Transplantation 18, (2014), which has been published in final form at https://doi.org/10.1111/petr.12307. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.

In pediatric LDLT, graft reduction is sometimes required because of the graft size mismatch. Dividing the portal triad and hepatic veins with a linear stapler is a rapid and safe method of reduction. We herein present a case with a left lateral segment reduction achieved using a linear stapler after reperfusion in pediatric LDLT. The patient was a male who had previously undergone Kasai procedure for biliary atresia. We performed the LDLT with his father's lateral segment. According to the pre-operative volumetry, the GV/SLV ratio was 102.5%. As the patient's PV was narrow, sclerotic and thick, we decided to put an interposition with the IMV graft of the donor between the confluence and the graft PV. The graft PV was anastomosed to the IMV graft. The warm ischemic time was 34 min, and the cold ischemic time was 82 min. The ratio of the graft size to the recipient weight (G/R ratio) was 4.2%. After reperfusion, we found that the graft had poor perfusion and decided to reduce the graft size. We noted good perfusion in the residual area after the lateral edge was clamped with an intestinal clamp. The liver tissue was sufficiently fractured with an intestinal clamp and then was divided with a linear stapler. The final G/R ratio was 3.6%. The total length of the operation was 12 h and 20 min. The amount of blood lost was 430 mL. No surgical complications, including post-operative hemorrhage and bile leakage, were encountered. We believe that using the linear stapler decreased the duration of the operation and was an acceptable technique for reducing the graft after reperfusion.

© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

99834

A case of pediatric live-donor liver transplantation with a left lateral segment reduction by a linear stapler after reperfusion

John Wiley and Sons Inc

English

2014-08-13

Pediatric Transplantation

18

6

https://doi.org/10.1111/petr.12307

https://hdl.handle.net/11094/99834