Outcomes of Liver Transplantation in Low Weight Children After Reducing the Lateral Segment of a Living Donor, Adapting the Shape and Size of the Graft to the Needs of the Recipient

Study Overview
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Brief Summary
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The shortage of organs has always been a problem in pediatric liver transplants due to the lack of donors with an adequate size. Different techniques of hepatic reduction have been described that allow to use larger organs in the pediatric population. However, in these techniques the maximum reduction achieved by segments 2 and 3 is excessive for low-weight children. Since 1997 the liver transplantation group at Hospital Italiano de Buenos Aires has developed and practiced a technique called hepatic hyper-reduction, which consists in reducing the lateral segment of a living donor, adapting the shape and size of the graft to the needs of the recipient. The investigators have performed approximately 50 pediatric liver transplants with live donors in low weight children in whom the hyper-reduction technique has been applied. The aim of the present study is to describe postoperative morbidity and mortality and analyze overall and graft survival.

Official Title
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Short and Long-term Outcomes After Transplantation With Hyper-reduced Liver Grafts in Low-Weight Pediatric Recipients

Conditions
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Liver Transplantation, Low-weight Children, Hyper-reduced Liver Grafts

Intervention / Treatment
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* Procedure: Liver transplantation with hyper-reduced grafts


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: < or = 17 years old. Having undergone live donor liver transplantation. Having received hyper-reduced liver grafts At the Liver Transplantation Unit of the Hospital Italiano de Buenos Aires Between June 1997 and April 2018 Exclusion Criteria: > 17 years old. Cadaveric liver transplant Whole liver grafts.

Ages Eligible for Study
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Minimum Age: 5 Months
Maximum Age: 17 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Hyper-reduced liver recipients.<br>Low-weight children who underwent live donor liver transplantation with ultrasound-guided in situ left lateral segment graft hyper-reduction. | Procedure: Liver transplantation with hyper-reduced grafts<br>* Live donor liver transplantation using non-anatomical in-situ ultrasound-guided reduction of left lateral segments with preparation of a graft that is larger than a monosegment, but smaller than Segments 2 and 3.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Overall survival at 10 years. | Overall survival was defined as the time from surgery to death (all causes) or date of last follow-up, measured in months. | Overall survival wil be reported at 10 years after liver transplantation. | 
| Graft survival at 1 year. | Graft survival was defined as the time from surgery to the date of re-transplantation or re-entry to waiting list, measured in months. | Graft survival wil be reported at 1 year after liver transplantation. | 
| Graft survival at 3 years. | Graft survival was defined as the time from surgery to the date of re-transplantation or re-entry to waiting list, measured in months. | Graft survival wil be reported at 3 years after liver transplantation. | 
| Graft survival at 10 years. | Graft survival was defined as the time from surgery to the date of re-transplantation or re-entry to waiting list, measured in months. | Graft survival wil be reported at 10 years after liver transplantation. | 
| Overall survival at 1 year. | Overall survival was defined as the time from surgery to death (all causes) or date of last follow-up, measured in months. | Overall survival wil be reported at 1 year after liver transplantation. | 
| Overall survival at 3 years. | Overall survival was defined as the time from surgery to death (all causes) or date of last follow-up, measured in months. | Overall survival wil be reported at 3 years after liver transplantation. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Liver, Transplantation, Hyper-reduction, Graft survival, Overall survival