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  • Print publication year: 2011
  • Online publication date: September 2011

Chapter 26 - Pediatric liver transplantation

from Section 4 - Liver

Summary

Bilateral lung transplantation (BLT) has evolved into a routine procedure and is the most frequently performed method. Traditionally single lung transplantation (SLT) has been the procedure of choice in patients with non-infective end-stage lung disease such as chronic obstructive pulmonary disorder (COPD) and idiopathic pulmonary fibrosis (IPF). Most common incisions for SLT are the posterolateral thoracotomy, anterolateral thoracotomy and median sternotomy, which are usually used if cardiopulmonary bypass (CPB) has to be employed. The preferred surgical incision for BLT is a bilateral transverse thoracotomy joint across the middle, best known as a clamshell incision. Cannulation for CPB is achieved using the ascending aorta and both the inferior vena cava (IVC) and superior vena cava (SVC) with tapes around for sealed occlusion. After intensive animal research and clinical experience gained from kidney and liver donation, the technique of lung donation after cardiac death (DCD) has been established successfully in recent years.

Further reading

BartlettA, RelaM. Progress in surgical techniques in pediatric liver transplantation. Pediatr Transplant 2010; 14: 33–40.
BucuvalasJ. Long-term outcomes in pediatric liver transplantation. Liver Transpl 2009; 15: S6–11.
DhawanA. Etiology and prognosis of acute liver failure in children. Liver Transpl 2008; 14: S80–4.
DuffyJ, KaoK, KoC, et al. Long-term patient outcome and quality of life after liver transplantation: analysis of 20-year survivors. Ann Surg 2010; 252: 652–61.
HartleyJ, DavenportM, KellyD. Biliary atresia. Lancet 2009; 374: 1704–13.
Mieli-VerganiG, VerganiD. Autoimmune paediatric liver disease. World J Gastroenterol 2008; 14: 3360–7.
MuiesanP, VerganiD, Mieli-VerganiG. Liver transplantation in children. J Hepatol 2007; 46: 340–8.