Pediatric living donor liver transplantation: results of laparoscopic vs. open graft removal.

Autor: Crehuet Gramatyka D; La Fe University and Polytechnic Hospital. Valencia (Spain)., Domènech Tàrrega A; La Fe University and Polytechnic Hospital. Valencia (Spain)., Driller C; La Fe University and Polytechnic Hospital. Valencia (Spain)., Mangas Álvarez L; La Fe University and Polytechnic Hospital. Valencia (Spain)., Maupoey Ibáñez J; La Fe University and Polytechnic Hospital. Valencia (Spain)., Diéguez Hernández-Baquero I; La Fe University and Polytechnic Hospital. Valencia (Spain)., Negrín Rodríguez F; La Fe University and Polytechnic Hospital. Valencia (Spain)., Martínez Gómez M; La Fe University and Polytechnic Hospital. Valencia (Spain)., Vigúria Marco I; La Fe University and Polytechnic Hospital. Valencia (Spain)., Vila Carbó JJ; La Fe University and Polytechnic Hospital. Valencia (Spain).
Jazyk: English; Spanish; Castilian
Zdroj: Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica [Cir Pediatr] 2022 Apr 01; Vol. 35 (2), pp. 63-69. Date of Electronic Publication: 2022 Apr 01.
DOI: 10.54847/cp.2022.02.13
Abstrakt: Introduction: Laparoscopic graft removal for pediatric living donor liver transplantation (PLDLT) reduces morbidity and surgical aggressiveness for the donor. It is important to assess whether the approach used for removal purposes compromises implantation. The objective of this study was to analyze PLDLT progression in children according to whether the graft had been removed laparoscopically or through open surgery.
Material and Methods: A retrospective, analytical cohort study of PLDLTs carried out in our institution from 2009 to 2020 was carried out.
Results: Transplantation was performed in 14 patients, with a median age of 34.5 (R: 6-187) months. In 6 donors (42%), graft removal was conducted laparoscopically. In 1 donor (7%), removal was initiated laparoscopically, but conversion was required. This patient was included within the open surgery group, which consisted of 8 (58%) donors. No differences were found in terms of operating times, ICU stay, hospital stay, complications during admission, or complications post-admission in the recipient. The surgical approach did not compromise the length of the vessels to be anastomosed in any graft, and it added no extra difficulty to implantation. No differences were found in terms of removal times or hospital stay for the donor. Only 1 donor from the laparoscopy group required re-intervention due to bleeding following port insertion.
Conclusion: PLDLT patients had similar results regardless of the removal approach used, which did not compromise the structures of the graft to be anastomosed, or add any extra difficulty to implantation.
Databáze: MEDLINE
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