Outcome of pediatric live-donor liver transplantation-the Toronto experience

J Pediatr Surg. 2003 May;38(5):668-71. doi: 10.1016/jpsu.2003.50179.


Background/purpose: Live-donor liver transplantation (LDLT) has developed to address the critical shortage of cadaveric organs that accounts for 20% of children who die while awaiting for a liver transplant in Ontario each year. This report reviews the outcome of the pediatric recipients of LDLT at the authors' center.

Methods: The charts of all children who received a LDLT between June 1996 and March 2002 were reviewed retrospectively.

Results: Thirteen children (mean age, 3.6 years) underwent LDLT. All donors were parents except for one cousin. Ten grafts were left-lateral segments, 2 were right lobes, and 1 was a left lobe. Three patients required a SILASTIC((R)) (Dow Corning, Midland, MI) patch for delayed abdominal wall closure. Patient and graft survival rate was 100% with a median follow-up of 376 days. Major postoperative complications included biliary leaks (n = 2), biliary strictures (n = 1), portal vein thrombosis (n = 1), and hepatic venous complications (n = 1). There were no cases of hepatic artery thrombosis. Ten of 12 children became Positive for Epstein-Barr virus (EBV), and 3 of these patients had readily treatable post-transplant lymphoproliferative disorder.

Conclusions: LDLT is an acceptable alternative to cadaveric transplantation for children with end-stage liver disease.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Graft Survival
  • Herpesvirus 4, Human / isolation & purification
  • Humans
  • Infant
  • Liver Diseases / surgery*
  • Liver Transplantation*
  • Living Donors*
  • Male
  • Postoperative Complications
  • Retrospective Studies
  • Treatment Outcome