REDUCED-SIZE GRAFTS - THE SOLUTION FOR HEPATIC-ARTERY THROMBOSIS AFTER PEDIATRIC LIVER-TRANSPLANTATION

Reduced size liver grafts (RSG) were developed to alleviate the donor shortage for pediatric patients, particularly those requiring emergenc y transplantation. In theory, the large size of the hepatic artery ava ilable for anastomosis from RSG, as opposed to whole pediatric grafts, is less likely to lead to hepatic artery thrombosis (HAT). Therefore, the authors reviewed their experience with HAT, comparing RSG and who le-liver grafts in pediatric patients undergoing emergency liver trans plantation. Despite the severity of illness of the recipients (UNOS st atus IV), and the intrinsic damage to the graft during reduction, HAT was not seen after RSG for emergency pediatric transplantation. in con trast, 29% of pediatric recipients who received whole grafts for emerg ency transplantation had HAT. RSG is a safe alternative to whole-liver grafts for pediatric liver transplantation, and may reduce the incide nce of HAT. Copyright (C) 1995 by W.B. Saunders Company