Challenging the Traditional Paradigm of Supply and Demand in Pediatric Liver Transplantation Through Nondirected Living Donation: A Case Series

  • Dor Yoeli
    Division of Transplantation,Department of Surgery,University of Colorado School of Medicine,Aurora,CO
  • Whitney E. Jackson
    Division of Gastroenterology and Hepatology,Department of Medicine,University of Colorado School of Medicine,Aurora,CO
  • Megan A. Adams
    Division of Transplantation,Department of Surgery,University of Colorado School of Medicine,Aurora,CO
  • Michael E. Wachs
    Division of Transplantation,Department of Surgery,University of Colorado School of Medicine,Aurora,CO
  • Shikha S. Sundaram
    Division of Gastroenterology, Hepatology and Nutrition, The Digestive Health Institute, Department of Pediatric Medicine,Children’s Hospital of Colorado,University of Colorado School of Medicine,Aurora,CO
  • Anna Sater
    Division of Abdominal Transplant Surgery,Department of Surgery,Children’s Hospital Colorado,Aurora,CO
  • Jaime R. Cisek
    Division of Transplantation,Department of Surgery,University of Colorado School of Medicine,Aurora,CO
  • Rashikh A. Choudhury
    Division of Transplantation,Department of Surgery,University of Colorado School of Medicine,Aurora,CO
  • Trevor L. Nydam
    Division of Transplantation,Department of Surgery,University of Colorado School of Medicine,Aurora,CO
  • James J. Pomposelli
    Division of Transplantation,Department of Surgery,University of Colorado School of Medicine,Aurora,CO
  • Kendra D. Conzen
    Division of Transplantation,Department of Surgery,University of Colorado School of Medicine,Aurora,CO
  • Michael S. Kriss
    Division of Gastroenterology and Hepatology,Department of Medicine,University of Colorado School of Medicine,Aurora,CO
  • James R. Burton
    Division of Gastroenterology and Hepatology,Department of Medicine,University of Colorado School of Medicine,Aurora,CO
  • Elizabeth A. Pomfret
    Division of Transplantation,Department of Surgery,University of Colorado School of Medicine,Aurora,CO

抄録

<jats:p>A gap exists between the demand for pediatric liver transplantation and the supply of appropriate size‐matched donors. We describe our center’s experience with pediatric liver transplantation using anonymous nondirected living liver donors (ND‐LLD). First‐time pediatric liver transplant candidates listed at our center between January 2012 and June 2020 were retrospectively reviewed and categorized by donor graft type, and recipients of ND‐LLD grafts were described. A total of 13 ND‐LLD pediatric liver transplantations were performed, including 8 left lateral segments, 4 left lobes, and 1 right lobe. Of the ND‐LLD recipients, 5 had no directed living donor evaluated, whereas the remaining 8 (62%) had all potential directed donors ruled out during the evaluation process. Recipient and graft survival were 100% during a median follow‐up time of 445 (range, 70‐986) days. Of ND‐LLDs, 69% were previous living kidney donors, and 1 ND‐LLD went on to donate a kidney after liver donation. Of the ND‐LLDs, 46% were approved prior to the recipient being listed. Over time, the proportion of living donor transplants performed, specifically from ND‐LLDs, increased, and the number of children on the waiting list decreased. The introduction of ND‐LLDs to a pediatric liver transplant program can expand the benefit of living donor liver transplantation to children without a suitable directed living donor while achieving excellent outcomes for both the recipients and donors.</jats:p>

収録刊行物

  • Liver Transplantation

    Liver Transplantation 27 (10), 1392-1400, 2021-07-31

    Ovid Technologies (Wolters Kluwer Health)

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