Graft reduction using a powered stapler in pediatric living donor liver transplantation

Koichiro Yoshimaru, Toshiharu Matsuura, Yoshiaki Kinoshita, Makoto Hayashida, Yoshiaki Takahashi, Yusuke Yanagi, Norifumi Harimoto, Toru Ikegami, Hideaki Uchiyama, Tomoharu Yoshizumi, Yoshihiko Maehara, Tomoaki Taguchi

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Large-for-size syndrome is defined by inadequate tissue oxygenation, which results in vascular complications and graft compression after abdominal closure in living donor liver transplantation recipients. An accurate graft reduction that matches the optimal liver volume for the recipient is essential. We herein initially present the feasibility and safety of graft reduction using a powered stapler to obtain an optimal graft size. From October 1996 to October 2015, a total of eight graft reductions were performed using a powered stapler (group A; n=4) or by the conventional method using a cavitron ultrasonic surgical aspirator and portal triad suturing (group B; n=4). The background, intraoperative findings and the post-operative outcomes of these eight patients were retrospectively investigated. There were no statistically significant differences in the background of the patients in the two groups. Graft reduction was successfully achieved without any intraoperative complications in group A, whereas intraoperative complications, such as bleeding and bile leakage, occurred in two patients of group B. No post-operative surgical complications were detected on computed tomography; moreover, the serum aspartate aminotransferase level normalized significantly earlier in group A (P<.05). In summary, graft reduction using a powered stapler was feasible and safe in comparison with the conventional method.

Original languageEnglish
Article numbere12985
JournalPediatric Transplantation
Volume21
Issue number6
DOIs
Publication statusPublished - Sep 2017

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Living Donors
Liver Transplantation
Pediatrics
Transplants
Intraoperative Complications
Aspartate Aminotransferases
Ultrasonics
Bile
Blood Vessels
Tomography
Hemorrhage
Safety
Liver
Serum

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

Cite this

Graft reduction using a powered stapler in pediatric living donor liver transplantation. / Yoshimaru, Koichiro; Matsuura, Toshiharu; Kinoshita, Yoshiaki; Hayashida, Makoto; Takahashi, Yoshiaki; Yanagi, Yusuke; Harimoto, Norifumi; Ikegami, Toru; Uchiyama, Hideaki; Yoshizumi, Tomoharu; Maehara, Yoshihiko; Taguchi, Tomoaki.

In: Pediatric Transplantation, Vol. 21, No. 6, e12985, 09.2017.

Research output: Contribution to journalArticle

Yoshimaru, Koichiro ; Matsuura, Toshiharu ; Kinoshita, Yoshiaki ; Hayashida, Makoto ; Takahashi, Yoshiaki ; Yanagi, Yusuke ; Harimoto, Norifumi ; Ikegami, Toru ; Uchiyama, Hideaki ; Yoshizumi, Tomoharu ; Maehara, Yoshihiko ; Taguchi, Tomoaki. / Graft reduction using a powered stapler in pediatric living donor liver transplantation. In: Pediatric Transplantation. 2017 ; Vol. 21, No. 6.
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