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First report of successful transplantation of a pediatric donor liver graft after hypothermic machine perfusion.
- Source :
-
Pediatric transplantation [Pediatr Transplant] 2019 May; Vol. 23 (3), pp. e13362. Date of Electronic Publication: 2019 Feb 22. - Publication Year :
- 2019
-
Abstract
- One of the main limiting factors in pediatric liver transplantation is donor availability. For adults, DCD liver grafts are increasingly used to expand the donor pool. To improve outcome after DCD liver transplantation, ex situ machine perfusion is used as an alternative organ preservation strategy, with the supplemental value of providing oxygen to the graft during preservation. We here report the first successful transplantation of a pediatric DCD liver graft after hypothermic oxygenated machine perfusion. The full-size liver graft was derived from a 13-year-old, female DCD donor and was end-ischemic pretreated with dual hypothermic oxygenated machine perfusion. Arterial and portal pressures were set at 18 and 4 mm Hg, slightly lower than protocolized settings for adult livers. During 2 hours of machine perfusion, portal and arterial flows increased from 100 to 210 mL/min and 30 to 63 mL/min, respectively. The pretreated liver graft was implanted in a 16-year-old girl with progressive familial intrahepatic cholestasis type 2. Postoperative AST, ALT, and prothrombin time normalized within a week. The recipient quickly recovered and was discharged from the hospital after 18 days. One year after transplantation, she is in excellent condition with a completely normal liver function and histology. This case is the first report of successful transplantation of a pediatric DCD liver graft after hypothermic oxygenated machine perfusion and illustrates the potential role of ex situ machine perfusion in expanding the donor pool and improving outcome after pediatric liver transplantation.<br /> (© 2019 The Authors. Pediatric Transplantation Published by Wiley Periodicals, Inc.)
- Subjects :
- Adolescent
Alanine Transaminase metabolism
Aspartate Aminotransferases metabolism
Cholestasis, Intrahepatic surgery
Female
Graft Survival
Humans
Liver Transplantation methods
Oxygen metabolism
Pediatrics
Postoperative Period
Prothrombin Time
Tissue and Organ Procurement methods
Treatment Outcome
Liver surgery
Liver Transplantation instrumentation
Organ Preservation instrumentation
Organ Preservation methods
Perfusion
Subjects
Details
- Language :
- English
- ISSN :
- 1399-3046
- Volume :
- 23
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Pediatric transplantation
- Publication Type :
- Report
- Accession number :
- 30801955
- Full Text :
- https://doi.org/10.1111/petr.13362