Transplantation hepatique avec donneur vivant apparente chez l'enfant

Translated title of the contribution: Liver transplantation with a living related donor in children

Florence Lacaille, Jacques Belghiti, Frédérique Sauvat, Jean Luc Michel, Olivier Farges, Annick Rengeval, Sabine Sarnacki, Natacha Sayegh, Dominique Jan, Yann Revillon

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Objectives - Liver transplantation with living related donor has been recently developed to compensate for the insufficient number of liver grafts for children. The major problem is ethical because it implies voluntary mutilation of a healthy person. This paper report results in 37 living related donors. Patients - Recipients were followed in Enfants-Malades Hospital. Investigations and donor surgery were performed at the Digestive Surgery Unit of Beaujon Hospital. Results - One donor was re-operated for bleeding, and another one a biliary fistula treated with percutaneous drainage for one week. The post-operative course was uneventful in the other donors, with a follow-up of between 2 and 50 months. Thirty-three children are alive (90%), one of them underwent a second transplant for arterial thrombosis. Vascular and infectious complications, and the number of rejection episodes were the same as in transplantations with a deceased donor. Biliary complications were frequent (15 patients out of 37) and Significantly increased morbidity. A teenage boy who received a small graft (0.9% of his weight) presented initially with hepatic insufficiency without encephalopathy. Conclusion - This technique has been shown to have a good balance between benefits and risks. Our experience confirms this, especially in very young children. Each case should be discussed individually and parental consent should be obtained without external pressure. Experience with this technique should be continued and at the same time the use of cadaveric grafts should be optimized.

Translated title of the contributionLiver transplantation with a living related donor in children
Original languageFrench
Pages (from-to)710-716
Number of pages7
JournalGastroenterologie Clinique et Biologique
Volume23
Issue number6-7
StatePublished - 1999
Externally publishedYes

Keywords

  • Biliary complications
  • Liver transplantation
  • Living donor

ASJC Scopus subject areas

  • Gastroenterology

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