AI Article Synopsis

  • Liver transplantation (LT) is essential for treating children with severe liver disease, particularly using left lateral segment (LLS) grafts in split and living donor procedures.
  • Small infants face challenges with LLS grafts due to size mismatches, prompting investigations into reducing graft thickness to improve suitability.
  • Successful outcomes in a study from Tokyo show a 15-year graft survival rate of 89.9% for small infants receiving reduced-size LLS grafts, highlighting the importance of tailoring grafts to recipient size for better survival rates.

Article Abstract

Liver transplantation (LT) has become a vital treatment option for children with end-stage liver disease. Left lateral segment (LLS) grafts are particularly common in split and living donor LT for pediatric patients. However, challenges arise in small infants receiving LLS grafts, primarily due to graft-size mismatches, resulting in "large-for-size" grafts. To overcome this issue, the practice of further reducing grafts from the LLS to diminish graft thickness has been explored. Currently, the indication for reducing the thickness of LLS grafts includes recipients with a body weight (BW) under 5.0 kg, neonates with acute liver failure, or those with metabolic liver disease. At the National Center for Child Health and Development in Tokyo, Japan, among 131 recipients of reduced-size LLS grafts, a remarkable 15-year graft survival rate of 89.9% has been achieved in small infants. This success indicates that with experience and refinement of the technique, there's a trend towards improved graft survival in recipients with reduced-thickness LLS grafts. This advancement underscores the importance of BW-appropriate methods in graft selection to ensure exceptional outcomes in vulnerable pediatric patients in need of LT. These techniques' ongoing development and refinement are crucial in enhancing the survival rates and overall outcomes for these young patients.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10869284PMC
http://dx.doi.org/10.1016/j.jceh.2024.101349DOI Listing

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