Abstract:

Objective To compare the early graft function in biliary atresia patients after living donor liver transplantation and whole liver transplantation. Methods 22 children underwent pediatric liver transplantation for biliary atresia from January 2014 to June 2014 in Tianjin First Central Hospital. Among them，14 patientsunderwent living donor liver transplantation（LDLT group）using piggyback technique with left liver lobe，8 patients underwent whole liver transplantation without bypass（WLT group）. Pre-operative and intraoperativeclinical data and early postoperative liver function were compared retrospectively. Results There were no significant differences in age，gender，weight，preoperative Child-Pugh score，alanine aminotransferase（ALT），aspartate aminotransferase（AST），total bilirubin（TBil），direct bilirubin（DBil），intraoperative blood loss，blood transfusion，and graft weight between these two groups（P ＞ 0.05）. However，donor age was older in LDLT group〔（30.8±6.9）years vs.（8.6±6.0）months〕than that of WLT group，with longer operative time〔（11.6±1.3）hours vs.（9.2±1.5）hours〕and shorter cold ischemia time 〔（72.1±21.7）minutes vs.（458.75±127.72）minutes〕（P＜0.05 or P＜0.01）. Early after liver transplantation，ALT，AST，TBil，DBil decreased progressively（P＜0.05）. The ALT level of LDLT group（U/L ：1 294±1 127，

716.2±594.1，544.6±580.7，377.2±397.9，287.4±269.4）was significantly higher than that of WLT group（U/L ：425.0±458.3，335.0±374.5，246.7±259.7，173.0±189.2，122.2±98.31，P ＜ 0.05）on post operative day（POD）1，2，3，4，5，higher but without significant difference on POD 6 and 7（P ＞ 0.05）. There was no statistical significance in AST level between two groups（P ＞ 0.05）. The TBil and DBil levels of WLT group were higher on POD 1 ～ 4，but lower on POD 5 ～ 7 than that of LDLT group（P ＞ 0.05）. Conclusion The liver function recovered well early after operation in both groups. ALT level of LDLT group was higher than that of WLT group on POD 1 ～ 5，which was probably related to longer operative time and ischemia injury caused by operation. LDLT is being advocated as an effective method to better meet thewaiting-list needs and shorten the waiting time.