Laparoscopic living donor hepatectomy for liver transplantation in children

Cherqui, Daniel; Soubrane, Olivier; Husson, Emmanuel; Barshasz, Eric; Vignaux, O.; Ghimouz, Mourad; Branchereau, Sophie; Chardot, Christophe; Gauthier, F.; Fagniez, Pierre Louis; Houssin, D

doi:10.1016/s0140-6736(02)07598-0

Cited by 372 publications

(277 citation statements)

References 23 publications

Supporting

Mentioning

260

Contrasting

Unclassified

Order By: Relevance

“…Laparoscopic left lobe procurement has been performed in some centers with even further reduced morbidity, without sacrificing graft integrity, [40][41][42] making dual left lobe donation more acceptable. On the other hand, various graft inflow modulation (GIM) procedures are currently being used to reduce the hyperperfusion stress on SFS grafts.…”

Section: Ethical Debatesmentioning

confidence: 99%

Living donor liver transplantation using dual grafts: Experience and lessons learned from cases worldwide

Chen

Yeh

et al. 2015

Liver Transpl

View full text Add to dashboard Cite

In living donor liver transplantation (LDLT), insufficient graft volume could result in small-for-size syndrome in recipients, whereas major liver donation predisposes the donor to a high risk of posthepatectomy liver failure. Dual graft LDLT is therefore introduced to obtain combined graft sufficiency. To date, 367 patients have been reported worldwide. We reviewed all the relevant literature, with a special focus on 43 case reports containing enough data to extract and analyze. A simple decision-making algorithm was developed. Dual graft LDLT is indicated when (1) a single donation is unacceptable due to graft-to-recipient size mismatch; (2) the future liver remnant is insufficient in the single donor after major resection; or (3) there is a significant underlying disorder or anatomical variation within the donor liver. The outcome of dual graft LDLT is reported to be comparable with that of single donor LDLT. Unilateral graft atrophy was found in 7 of the 43 patients, predominantly in the right-sided, heterotopic and initially smaller grafts. Technically, the heterotopic implantation and complex vascular reconstruction are the most demanding. Elaborate surgical planning and modification are needed. Ethical concerns about involving a second living donor need to be addressed. In conclusion, dual graft LDLT should be prudently performed in select cases by surgeons of proven expertise when single donation is unacceptable and a second living donor is available. The decision-making criteria need to be standardized. More surgical modification and clinical research are needed. Liver transplantation (LT) is now a gold standard treatment for patients with end-stage or irreversible liver disease, which may restore liver function and yield optimal oncologic outcome as well. The shortage of organ donors, however, has long been the main obstacle in LT activities. Various surgical strategies have been adopted to address the increasing donor-recipient disproportion, including cadaveric split liver transplantation (SLT),

show abstract

Section: Ethical Debatesmentioning

confidence: 99%

Living donor liver transplantation using dual grafts: Experience and lessons learned from cases worldwide

Chen

Yeh

et al. 2015

Liver Transpl

View full text Add to dashboard Cite

show abstract

“…Examination of the donor liver showed no contraindications. Total donor liver volume was 1,925 cm 3 . Left liver without caudate, including middle hepatic vein (MHV), 610 cm 3 .…”

Section: Donormentioning

confidence: 99%

“…In 2002, one of us performed the first laparoscopic living donor hepatectomy for LDLT in children (3). Safety and reproducibility of the procedure were then established on a larger series (4) and the approach successfully adopted by other groups (5).…”

Section: Introductionmentioning

confidence: 99%

Totally Laparoscopic Full Left Hepatectomy for Living Donor Liver Transplantation in Adolescents and Adults

Samstein

Cherqui

Rotellar³

et al. 2013

American Journal of Transplantation

View full text Add to dashboard Cite

In recent years different minimal access strategies have been designed in order to perform living donor liver surgery for adult recipients with less morbidity. Techniques involve shortening the length of the incision with or without previous laparoscopic mobilization of the liver. Herein we present two cases of totally laparoscopic living donor left hepatectomy, with and without removal of the middle hepatic vein, respectively. We describe in detail the anatomical and technical aspects of the procedure focusing on relevant points to enhance safety.Key words: Adult, laparoscopy, left lobe graft, live donor transplantation, liver transplantation Abbreviations: GRWR, graft to recipient weight ratio; LDLT, means living donor liver transplant; LHV, left hepatic vein; MHV, middle hepatic vein.

show abstract

“…The surgical details of both techniques have been explained elsewhere [28,[31][32][33]. Performing the donor hepatectomy laparoscopically reduces post-operative morbidity and shortens recovery time for the donor [34].…”

Section: Split Liver Transplantationmentioning

confidence: 99%

Pediatric Liver Transplantation: A Surgical Perspective and New Concepts

et al. 2014

View full text Add to dashboard Cite

The first successful liver transplantation was carried out in 1967, and the recipient was a pediatric patient. Since then, many challenges have been overcome and, nowadays, 1-year patient survival after liver transplantation is about 90 % in pediatric patient populations. Standardization of surgical technique, development of better immunosuppressive medications, improved understanding of caring for patients with end-stage liver disease, and improvements in anesthesia and intensive care have had a tremendous impact on graft and patient survival. Despite all improvements, challenging issues in pediatric liver transplantation remain. In this article, we address some of these problems. and living donor liver transplantation (LDLT); improvement of intensive care treatment; development of new immunosuppressive medications; improved understanding of the balance between immunosuppression and opportunistic infection; and the adoption of a multidisciplinary team approach to patient care, which includes collaboration between transplant surgery, pediatric hepatology, pediatric intensive care, nephrology, pulmonary, cardiology, infectious disease, psychiatry, social work, pharmacy, and nutrition.Despite these good outcomes, many challenges remain in pediatric LT. Appropriate patient selection, organ shortage and the organ allocation algorithm, time of transplantation, technical problems, and opportunistic infections are some of the problems faced by transplant programs on a daily basis. This chapter addresses some of these issues.

show abstract

Laparoscopic living donor hepatectomy for liver transplantation in children

Cited by 372 publications

References 23 publications

Living donor liver transplantation using dual grafts: Experience and lessons learned from cases worldwide

Living donor liver transplantation using dual grafts: Experience and lessons learned from cases worldwide

Totally Laparoscopic Full Left Hepatectomy for Living Donor Liver Transplantation in Adolescents and Adults

Pediatric Liver Transplantation: A Surgical Perspective and New Concepts

Contact Info

Product

Resources

About