First report of successful transplantation of a pediatric donor liver graft after hypothermic machine perfusion

Pediatric Transplantation
Maureen J M WernerRobert J Porte

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 excell...Continue Reading

References

Jun 30, 2009·Journal of Pediatric Gastroenterology and Nutrition·Huiqi YangJan B F Hulscher
Jan 15, 2010·Pediatric Transplantation·S GozziniK Sharif
Apr 16, 2010·The British Journal of Surgery·J DubbeldB van Hoek
Jun 16, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·J A WertheimR W Busuttil
Nov 22, 2011·The Journal of Surgical Research·Hongzhi XuMartin Hertl
Oct 16, 2012·Journal of Hepatology·Andrea SchlegelPhilipp Dutkowski
May 24, 2014·Transplant International : Official Journal of the European Society for Organ Transplantation·Andrea Schlegel, Philipp Dutkowski
Jan 12, 2016·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·R RavikumarP J Friend
Jan 26, 2018·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Rianne van RijnRobert J Porte
Jan 30, 2018·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Hubert P J van der DoefUNKNOWN for pediatric liver transplantation centers of Eurotransplant
Apr 13, 2018·Journal of Surgical Case Reports·Barney T F StephensonDarius F Mirza

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Citations

Mar 21, 2020·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Davide CussaRenato Romagnoli
Jun 11, 2020·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Davide GhinolfiUmberto Cillo
Mar 3, 2021·Current Opinion in Organ Transplantation·Hanns Lembach JahnsenDarius F Mirza
Nov 19, 2021·The British Journal of Surgery·Belle LiewDimitri A Raptis

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