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Adult liver transplantation using pediatric donor livers after cardiac or brain death: A report of three cases

  • Authors:
    • Limin Ding
    • Lishan Deng
    • Xinchang Li
    • Zhidan Xu
  • View Affiliations / Copyright

    Affiliations: Department of Transplantation, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, Jiangxi 330000, P.R. China, Secretarial Section, Jiangxi Provincial Cultural and Sports Management Center for the Disablede, Nanchang, Jiangxi 330000, P.R. China
    Copyright: © Ding et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 27
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    Published online on: August 31, 2020
       https://doi.org/10.3892/etm.2020.9155
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Abstract

The present study reports on the experience at Jiangxi Provincial People's Hospital (Nanchang, China) with liver transplantation in adults using pediatric donor livers, including indications, technique and results. A total of three cases of liver transplantation performed between April 2008 and May 2016 were retrospectively reviewed. Liver procurement and trimming, recipient selection, surgical tips, prevention and treatment of small‑for‑size syndrome, selection of immunosuppressive regimens, prevention and treatment of vascular complications and anticoagulant therapy were discussed. The three pediatric donors were 8, 8 and 10 years old. The three recipients were confirmed to have primary liver cancer. In recipient 1 (female; age, 39 years), jaundice persisted in the recipient after the liver transplantation. A reduced dose of FK506 was then given to gradually decrease the total bilirubin level to the normal range. Recipient 1 recovered and was discharged from hospital; however, the patient died of liver cancer recurrence and bone metastasis 6 years post‑transplantation. In recipient 2 (male; age, 56 years), the recipient experienced sudden abdominal distension on postoperative day 7. The patient's clotting time was prolonged and the transaminase level was sharply increased, peaking on day 9. The patient was suspected of having small‑for‑size syndrome and was treated symptomatically. The patient experienced a significant improvement in symptoms on postoperative day 13 and regular postoperative follow‑ups were performed until now and the patient is now in remission. In recipient 3 (male; age, 48 years), the recipient recovered well and the liver function returned to normal on postoperative day 3. The patient was discharged from hospital and has been in remission thus far. Adult liver transplantations from pediatric donors are feasible treatments. Systematic donor and recipient assessments, sound surgical skills and optimal postoperative treatments are essential for success in the transplantation of livers from pediatric donors into adult recipients. Considering the condition of the donor liver, the selection of recipients and appropriate surgical methods are particularly important in these cases.
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Copy and paste a formatted citation
Spandidos Publications style
Ding L, Deng L, Li X and Xu Z: Adult liver transplantation using pediatric donor livers after cardiac or brain death: A report of three cases. Exp Ther Med 20: 27, 2020.
APA
Ding, L., Deng, L., Li, X., & Xu, Z. (2020). Adult liver transplantation using pediatric donor livers after cardiac or brain death: A report of three cases. Experimental and Therapeutic Medicine, 20, 27. https://doi.org/10.3892/etm.2020.9155
MLA
Ding, L., Deng, L., Li, X., Xu, Z."Adult liver transplantation using pediatric donor livers after cardiac or brain death: A report of three cases". Experimental and Therapeutic Medicine 20.5 (2020): 27.
Chicago
Ding, L., Deng, L., Li, X., Xu, Z."Adult liver transplantation using pediatric donor livers after cardiac or brain death: A report of three cases". Experimental and Therapeutic Medicine 20, no. 5 (2020): 27. https://doi.org/10.3892/etm.2020.9155
Copy and paste a formatted citation
x
Spandidos Publications style
Ding L, Deng L, Li X and Xu Z: Adult liver transplantation using pediatric donor livers after cardiac or brain death: A report of three cases. Exp Ther Med 20: 27, 2020.
APA
Ding, L., Deng, L., Li, X., & Xu, Z. (2020). Adult liver transplantation using pediatric donor livers after cardiac or brain death: A report of three cases. Experimental and Therapeutic Medicine, 20, 27. https://doi.org/10.3892/etm.2020.9155
MLA
Ding, L., Deng, L., Li, X., Xu, Z."Adult liver transplantation using pediatric donor livers after cardiac or brain death: A report of three cases". Experimental and Therapeutic Medicine 20.5 (2020): 27.
Chicago
Ding, L., Deng, L., Li, X., Xu, Z."Adult liver transplantation using pediatric donor livers after cardiac or brain death: A report of three cases". Experimental and Therapeutic Medicine 20, no. 5 (2020): 27. https://doi.org/10.3892/etm.2020.9155
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