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Abstract:

Objective To explore the clinical efficacy of domino liver transplantation（DLT）in the treatment of liver diseases in children. Methods This study included 3 groups of 6 patients with DLT，including 2 living donors（LD）and 1 brain death donor，3 MSUD patients and 3 DLT recipients were enrolled. Each group ofDLT donors and recipients underwent surgery at the same time. The left lateral segment was obtained from theliving donor，and the whole liver was obtained from the donation after brain death（DBD）donor，angioplasty wasselectively performed according to the blood vessel conditions of the donor liver. All patients with MSUD had theirliver removed，two patients received living donor liver transplantation（LDLT）and 1 patient received DBD donorliver transplantation. The diseased liver of DLT recipients were removed and livers from MSUD patient’s wereimplanted. Results The liver function of 3 patients with MSUD returned to the normal range within 2 weeks after operation，and the blood flow of transplanted liver was normal. In 3 DLT recipients，bilirubin basically returned tothe normal range within 2 weeks after operation，and the blood flow of the transplanted liver was normal. One of MSUD patients had portal venous anastomotic stenosis after 1 month，it was improved after balloon dilation. A patient

with MSUD had acute cellular rejection after 2 weeks and was improved with steroid bolus therapy. One case ofDLT recipient experienced acute rejection after 1 week and was improved after steroid bolus therapy. One of DLTrecipient developed lung infection after 1 week，the patient stayed in intensive care unit（ICU）for a long time，and was improved with anti-infective treatment. During the follow-up period（8 ～ 16 months），all liver transplant patients and grafts survived. Conclusion It is technically feasible to apply livers of MSUD patients as DLT donors. Favorable outcome has been achieved and it will expand the source of organs to a certain degree.

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