Favorable outcomes seen with living donor liver transplantation in small infants

Living donor liver transplantation (LDLT) in patients <6 months old is difficult to perform but leads to favorable outcomes, according to a study.

Between 2004 and 2019, a total of 9 patients <6 months old underwent LDLT at a single hospital. Transplantation was indicated due to biliary atresia in 2 patients, Alagille syndrome in 1 patient, protein C deficiency in 1 patient, and acute liver failure in 5 patients. Graft types included left lateral segment (LLS) in 4 patients, hyper-reduced LLS in 4 patients, and monosegment in 1 patient. The median graft-to-recipient weight ratio was 4%.

Over a median follow-up period of 14 months, 2 patients died and 2 were weaned off immunosuppressants. All patients with giant cell hepatitis and hemophagocytosis required adjuvant therapies.

Researchers noted that preoperative reconstructive imaging was used to estimate graft thickness and aide in surgical planning.

Reference
Yeh YT, Liu C, Tsai HL, et al. Living donor liver transplantation for small infants aged less than 6 months: The experience of a single institute. J Pediatr Surg. 2021;56(7):1157-1161. DOI: 10.1016/j.jpedsurg.2021.03.022. Epub 2021 Mar 24. PMID: 33840505.