Liver Transplantation in Children Weighing Less Than 10 kg: Chilean Experience

Uribe, Mario; Alba, A.; Hunter, B.; González, G.; Godoy, J.; Ferrario, M.; Buckel, E.; Cavallieri, S.; Heine, C.; Rebolledo, R.; Auad, H.; Acuña, Carlos

doi:10.1016/j.transproceed.2013.08.092

Cited by 12 publications

(16 citation statements)

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“…The PELDS and the Z-score, an anthropometric parameter for malnutrition [17] , indicated that the medical conditions of the G1 patients were indeed worse and that their indications for liver transplantation were relatively urgent compared with those for the G2 patients. Furthermore, more challenging complications and difficulties are to be expected in LT for pediatric patients weighing less than 10 kg [1][2][3][4] . Table 3 further revealed that the total anesthesia time for G1 patients was significantly longer than that for G2 patients, most likely because of more difficult placement of arterial lines and the central venous catheter.…”

Section: Discussionmentioning

confidence: 99%

“…Performing living donor liver transplantation (LDLT) for pediatric patients, especially those with body weights of less than 10 kg, poses a challenge for all the participants in the liver transplant team, including anesthesiologists [1,2] . The outcomes of such transplants for pediatric patients weighing less than 10 kg differ from those for pediatric patients weighing more than 10 kg [1][2][3][4] .…”

Section: Introductionmentioning

confidence: 99%

“…The outcomes of such transplants for pediatric patients weighing less than 10 kg differ from those for pediatric patients weighing more than 10 kg [1][2][3][4] . We have previously reported that the average change in core temperature during an LDLT for pediatric patients weighing less than 10 kg is significantly different from that in heavier children [5] .…”

Section: Introductionmentioning

confidence: 99%

“…In pediatric kidney transplantation, the ideal body weight for a recipient has also been found to be greater than 10 kg [8] . Most of the previous reports regarding pediatric organ transplantation have primarily evaluated the outcomes in terms of the morbidity and mortality of the procedure in question [1][2][3][4] . However, little information can be found in the literature concerning the anesthetic fluid requirements for pediatric patients with different body weights undergoing LDLT.…”

Section: Introductionmentioning

confidence: 99%

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Living donor liver transplantation with body-weight more or less than 10 kilograms

Yang

Huang

Chen

et al. 2015

WJG

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AIM:To compare the outcomes of pediatric patients weighing less than or more than 10 kg who underwent liver transplantation. METHODS: Data for 196 pediatric patients who underwent living donor liver transplantation betweenJune 1994 and February 2011 were reviewed retrospectively. The information for each patient was anonymized and de-identified before analysis. The data included information regarding the pre-transplant conditions, intraoperative fluid replacement and outcomes for each patient. The 196 patients were divided into two groups: those with body weights of less than 10 kg were included in group 1 (G1; n = 101), while those with body weights of more than 10 kg were included in group 2 (G2; n = 95). For each group, the patients' ages, body weights, heights, pediatric end stage liver disease scores, anesthesia times, and warm and cold ischemic times were analyzed. In addition, between-group comparisons were also made. Mann-Whitney U tests were used to compare all the variables except for complications and survival rates, which were analyzed using χ 2 tests and Kaplan-Meier tests, respectively. RESULTS:The general medical conditions of the G1 Retrospective StudyLiving donor liver transplantation with body-weight more or less than 10 kilograms patients were worse than those of the G2 patients, as shown by the higher pediatric end stage liver disease scores and poorer Z -scores. In addition, the preoperative Hb and serum albumin levels were all lower for the G1 patients than for the G2 patients. The G1 patients also had significantly more intraoperative blood loss than the G2 patients. In addition, the intraoperative fluid requirements for the G1 patients, including leukocyte poor red blood cell transfusions, 5% albumin infusions and crystalloid infusions, were significantly higher than those for the G2 patients. The risk of intraoperative portal vein thrombosis was higher for the patients in G1 than for those in G2. However, the one-year survival rates (95.9% and 96.8% for G1 and G2, respectively) and three-year survival rates (94.9% and 94.6% for G1 and G2, respectively) for both groups were similar. CONCLUSION:Patients weighing less than 10 kg typically have poorer conditions, but their survival rates are comparable to those of children weighing more than 10 kg. Core tip: Although pediatric patients weighing less than 10 kg who underwent living donor liver transplantation usually had worse pre-transplant conditions, more intraoperative bleeding and more portal vein complications, their three-year survival rate was 94%, a rate comparable to that achieved by children weighing more than 10 kg. A prerequisite for achieving these excellent results is good and effective teamwork. Cooperation between surgeons, plastic surgeons, and anesthesiologists in the operating theater is fundamental, but the contributions of radiologists are also critical. Radiologists should be available in the operating room to perform Doppler ultrasounds or place vascular stents, as required.Yang SC, Huang CJ, Chen CL, Wang CH,...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Living donor liver transplantation with body-weight more or less than 10 kilograms

Yang

Huang

Chen

et al. 2015

WJG

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show abstract

“…4,6 Literatürde 10 kg altı nakillerde mortalite oranı %65-75 olarak bildirilmiştir. 4 Bizim grubumuzda da 2 hastamız 10 kg altında idi. Bu hastalardan…”

Section: Discussionunclassified