Pediatric Living Donor Liver Transplantation at KFSH&RC – Implementation of the Laparoscopic Retrieval in a High Volume Center
Organ Transplant Centre, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.
Meeting: 2015 American Transplant Congress
Abstract number: A73
Keywords: Laparoscopy, Liver transplantation, Living-related liver donors, Pediatric
Session Information
Session Name: Poster Session A: Donor Management: All Organs
Session Type: Poster Session
Date: Saturday, May 2, 2015
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Exhibit Hall E
Since the first successful pediatric liver transplantation was performed in 1967 the survival rate increased from 30 % to currently above 90 %. This is owed to the introduction of cyclosporine in the early eighties. Another problem was the lack of available size matched liver donors, which caused high death rates on the waiting list of pediatric recipients. Technical innovations based on the segmental anatomy of the liver, e.g. reduced liver grafts, split grafts and living liver transplantation addressed this problem. The last big advantage was the implementation of FK 506 Tacrolimus, which allows steroid withdrawal within the first year post-transplant and preserves the growth potential of children.
A new task in living related pediatric liver transplantation is the implementation of the laparoscopic retrieval technique.
Our own program performed between 2011 and 2014 a total of 156 pediatric liver transplantations with a 92 percentage of living related donors. In our series 38.4 % of the children were below one year old with a predominance of genetic-metabolic diseases of 48.2 %. In contrast to other countries biliary atresia was the indication for transplant only in 29.5 %, 7.1 % showed end stage liver disease of unknown reason.
Our results show a recipient and graft survival of 93 and 89 % respectively. The morbidity was 17 % for surgical and 18 % for medical complications. The biopsy proven rejection rate was 7 %. Six children died after discharge at home or in peripheral hospitals for unknown reasons.
In accordance with other centers the rate of grafts from living donors clearly prevails deceased grafts. We implemented the laparoscopic approach in left lateral living donation. The donor complication rate was similar between the minimal invasive and open procedure, while the post donation hospital stay was reduced in the minimal invasive group.
Therefore laparoscopic retrieval procedure should become standard on the donor side in pediatric living donor transplantation.
To cite this abstract in AMA style:
Boehnert M, Shagrani M, Goufi TAl, Broering D. Pediatric Living Donor Liver Transplantation at KFSH&RC – Implementation of the Laparoscopic Retrieval in a High Volume Center [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/pediatric-living-donor-liver-transplantation-at-kfsh-implementation-of-the-laparoscopic-retrieval-in-a-high-volume-center/. Accessed November 21, 2024.« Back to 2015 American Transplant Congress