Abstract:

Objective To report one case of reduced-size liver transplantation in the treatment of children with congenital segment reported cases of biliary atresia. Methods Reduced monosegmental liver transplantation was performed for one patient suffered congenital biliary atresia in our hospital in March 2014. Thepatient was 5 months old and 7 kg in weight. His mother donated her left lateral liver. Due to graft-to-recipientweight ratio（GRWR）was too high（5.14%），the left lateral donor liver was harvested and further reduced size invitro. The diseased liver of patient was removed with the vena cava reserved，then orthotopic liver transplantation was performed. Results Donor operative time was 6.5 hours and total amount of bleeding was 150 ml，donor recoveredwell and discharged 1 week after operation. Recipient operative time was 8.5 hours with 50 minutes of an-hepaticperiod. Reduced-size graft was 260 g and GRWR was reduced to 3.71%. Intraoperative methylprednisolone inductionand tripleimmunosuppressive regimen（tacrolimus + mycophenolate mofetil + methylprednisolone）were applied forrecipient. Recipient condition was well and liver function return to normal level 25 days after operation. Abdominalultrasound suggest normal hemodynamics and increasing volume of graft liver. Recipient was discharged 35 days afteroperation and abdominal wound healed with A level. Both donor and recipient were followed up 6 months without any complications. Conclusion To prevent complications associated with large-for-size grafts，further graft reduction could be necessary to overcome the large-for-size graft syndrome，the reduced monosegmental liver transplantationis an safe and effective selection which was based on accurate preoperative radiological assessment of the graft andexcellent perioperative care and management to the patient.