Application and analysis of segment 2 monosegment graft in pediatric living donor liver transplantation

Abstract

Objective To analyze the values and characteristics of segment 2 monosegment graft in living donor liver transplantation for pediatric recipients. Method The clinical data of 5 recipients and donors who were given living donor liver transplantation with segment 2 monosegment graft between Mar. 2015 to Jan. 2016 in our institution were collected, including weight of recipients, estimated and actual graft to recipient weight ratio (GRWR) of left lateral segment (LLS) and segment 2 (S2), primary abdominal closure or not, recovery of recipient liver function after the operation, and the signs of large for size syndrome or not. The characteristics of segment 2 monosegment graft in living donor liver transplantation for pediatric recipient and influence on recipient prognosis were analyzed. Result The median weight of recipients was 6.5 kg (4.6-8.0 kg), median estimate GRWR of LLS and S2 before operation was 5.74% (4.16%-7.30%) and 2.90% (2.50%-3.95%) respectively, and median actual GRWR of S2 was 2.92% (2.4%-3.3%) during the operation. All the 5 recipients achieved primary abdomen closure and their liver function recovered uneventfully without any signs of large for size syndrome and complications of vessels. Delayed bile leakage occurred in 1 recipient 18 days after operation and cured by percutaneous drainage. Conclusion Segment 2 monosegment is a graft type, which can be chosen to avoid large for size syndrome in pediatric living donor liver transplantation especially for low weight infantal recipients. Key words: Liver transplantation; Tissue and organ harvesting; Living donor; Child