Living related liver transplantation for children younger than one year old

Abstract

Living related liver transplantation (LRLT) is an effective modality to overcome the donor shortage in small children. We evaluated the safety of LRLT in case of recipients younger than 1 year of age.

Patients and methods: In 149 children who underwent LRLT, 44 were younger than 1 year. Original diagnosis were biliary atresia (42) and metabolic disorder (2). The body weight ranged from 3.1 to 9.3 kg. Preoperative risk factors, technical innovations, and survival rate were reviewed in comparison with those of older children.

Results: Encephalopathy and respiratory disturbance due to massive ascites or bronchotracheal malacia were leading risk factors which demanded ICU care preoperatively. In reconstruction of the portal vein venous graft was necessary more often in infants than in the older children. Incidence of vascular complications was not higher in infants than in the older children. Biliary complications were more frequent in the infants. Survival rate was 81.9%, which was comparable to that of the older recipients. Incidence of rejection and infection was not different between the infants and the older children.

Conclusion: LRLT in recipients younger than 1 year can be safely done with some precautions.