The impact of low recipient weight [≤ 7kg] on long-term outcomes in 1078 pediatric living donor liver transplantations

Neto, João Seda; Chapchap, Paulo; Feier, Flávia Heinz; Pugliese, Renata; Vincenzi, Rodrigo; Roda, Karina; Kondo, Mário; Fonseca, Eduardo A.

doi:10.1016/j.jpedsurg.2022.05.014

Cited by 3 publications

(6 citation statements)

References 29 publications

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“…RLLS/HRLLS are still the most used techniques compared to true MS, as shown in a recent systematic review regarding neonatal and infantile liver transplantation 3 . In our own experience, 19 of 322 (6.1%) patients with body weight ≤7 kg received RLLS/HRLLS grafts, and 33 (10.8%) required abdominal wall closure with a prosthetic mesh 6 . In face of this problem, a simple and safe technique for antero‐posterior (AP) graft reduction was developed, and is described in this article.…”

Section: Introductionmentioning

confidence: 75%

“…The antero‐posterior diameter “problem” was never properly addressed. In a cohort of 1078 pediatric LDLT, 6 322 patients had a BW ≤7 kg, 6.1% of the infants received RLLS/HRLLS, and 10.8% underwent delayed abdominal closure. Even though the patient and graft survival rates were similar (BW ≤7 kg vs BW >7 kg), ICU and hospital stay were significantly higher in the small recipients, similar to the findings of Molino et al 18 in a recent publication addressing delayed sequential abdominal closure.…”

Section: Discussionmentioning

confidence: 99%

“…Managing the size match and using appropriate techniques may be more crucial in neonates, 19 and knowing one's population and specific characteristics is essential for devising and implementing technical changes tailored for each transplant practice. In the last decade, our program received a larger number of patients <7 kg 6 ; only two patients were less than 4 kg, a situation where the use of a true monosegment could be implemented. Still there were cases that required second closure despite the use of RLLS/HRLLS.…”

Section: Discussionmentioning

confidence: 99%

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Anterior hepatic resection: A simple and safe technique for reducing the antero‐posterior diameter of the liver graft for small pediatric recipients

Neto

Costa

Pereira

et al. 2023

Pediatric Transplantation

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Background:The techniques involved in neonatal and infantile transplantation require approaches that can sculpt a left lateral segment (LLS) to the right shape and size and avoid large-for-size syndrome. The aim of this article is to describe the anterior hepatic resection (AHR) of the LLS in pediatric LDLT. Methods:A retrospective anatomical study of preoperative image studies, description of the technique for AHR, and short-term results. Results:The AHR was performed in eight cases. All donors were male, with average age, BW, and BMI of 28.3 ± 5.9 years, 74.2 ± 9.3 kg, and 24.3 ± 2.6 kg/m2, respectively. Donors were discharged at an average of 3.6 ± 0.8 days. The median recipient age and BW at transplantation were 6.9 (2.7 to 11) months and 5.9 (3.9 to 8) kg, respectively, and the recipient-to-donor body weight ratio (RDBW) was <0.1 in all but one case.The mean percentage reduction in graft weight and in the antero-posterior diameter were 33.2% ± 5.5% and 38.3% ± 12.6%, respectively. The average (SD) GRWR was 4.8% ± 1.7% before all the resections and 3.5% ± 1.0% after the procedures. Seven patients were primarily closed. Conclusion:After LLS resection, a nonanatomical anterior resection of the LLS was accomplished without hilar vascular dissection to segments II/III. The final liver graft allowed primary abdominal wall closure in all but one patient, with meaningful adjustments in GRWR. AHR proved to be simple, safe, reproducible, and effective in the presented case series.

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Section: Introductionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Anterior hepatic resection: A simple and safe technique for reducing the antero‐posterior diameter of the liver graft for small pediatric recipients

Neto

Costa

Pereira

et al. 2023

Pediatric Transplantation

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“…Most PLLD in this study were female, usually mothers, with a mean age of 29.2 years, and very low annual income. The national minimum wage in December 2021 in Brazil was $196 per month[ 9 ]; correspondingly, the annual income for 57% of the PLLD in this cohort was under $4704. This situation reflects the socioeconomic situation of our country, but the majority of liver transplantations were performed under Brazil's publicly-funded healthcare system (Sistema Único de Saúde), which covered all costs for donor and recipient care.…”

Section: Discussionmentioning

confidence: 99%

“…As for the remaining data in the comparison, although there are some common traits, we must point out that socio-demographic profiles are greatly influenced by cultural differences between countries and even by differences in the transplant centers assessing the patients. Despite the demographic differences encountered, the outcomes for donors and recipients reported by our group proved to be safe for donors[ 11 ] and with excellent short and long term results for the pediatric recipients[ 9 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Quality of life, depression and anxiety in potential living liver donors for pediatric recipients: A retrospective single center experience

Reine¹,

Feier²,

Fonseca³

et al. 2022

World J Hepatol

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BACKGROUND Living donor liver transplantation is a safe alternative for patients on a liver transplant list. Donor evaluation goes beyond physical variables to include social, emotional, and ethical aspects. The role of pre-donation sociopsychological evaluation of the donor candidate is as important to the success of the procedure as is the medical assessment. Success implies recovery from the operation and prompt engagement in pre-transplant professional and social activities, without leading to psychological or physical distress. Psychological profiling of potential living liver donors (PLLD) and evaluation of quality of life (QOL) can influence outcomes. AIM To evaluate the socio-demographics and psychological aspects (QOL, depression, and anxiety) of PLLD for pediatric liver transplantation in a cohort of 250 patients. METHODS This was a retrospective cohort study of 250 PLLD who underwent psychological pre-donation evaluation between 2015 and 2019. All the recipients were children. The Beck anxiety inventory, Beck depression inventory, and 36-item short-form health survey (SF-36) scores were used to evaluate anxiety (Beck anxiety inventory), depression (Beck depression inventory), and QOL, respectively. RESULTS A total of 250 PLLD were evaluated. Most of them were women (54.4%), and the mean age was 29.2 ± 7.2 years. A total of 120 (48.8%) PLLD were employed at the time of evaluation for donation; however, most had low income (57% earned < 2 times the minimum wage). A total of 110 patients (44%) did not finish the donation process, and 247 PLLD answered a questionnaire to evaluate depression, anxiety, and QOL (SF-36). Prevalence of depression was of 5.2% and anxiety 3.6%. Although most of the PLLD were optimistic regarding the donation process and never had doubts about becoming a donor, some traces of ambivalence were observed: 46% of the respondents said they would feel relieved if a deceased donor became available. CONCLUSION PLLD had a low prevalence of anxiety and depression. The foundation for effective and satisfactory results can be found in the pre-transplantation process, during which evaluations must follow rigorous criteria to mitigate potential harm in the future. Pre-donation psychological evaluation plays a predictive role in post-donation emotional responses and mental health issues. The impact of such findings on the donation process and outcomes needs to be further investigated.

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Nutrition and Epstein-Barr viremia in children underwent liver transplantation: A retrospective, cross-sectional study

Zhou,

Qian,

Zhang

et al. 2024

Clinical Nutrition ESPEN

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The impact of low recipient weight [≤ 7kg] on long-term outcomes in 1078 pediatric living donor liver transplantations

Cited by 3 publications

References 29 publications

Anterior hepatic resection: A simple and safe technique for reducing the antero‐posterior diameter of the liver graft for small pediatric recipients

Anterior hepatic resection: A simple and safe technique for reducing the antero‐posterior diameter of the liver graft for small pediatric recipients

Quality of life, depression and anxiety in potential living liver donors for pediatric recipients: A retrospective single center experience

Nutrition and Epstein-Barr viremia in children underwent liver transplantation: A retrospective, cross-sectional study

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