Feasibility and safety of using low-body-weight donors in pediatric liver transplantation.

Abstract

BACKGROUND\nDonors with low-body-weight were previously reported to be related to inferior recipient outcomes in pediatric liver transplantation. However, the scarce availability of age and size-matched organs has encouraged us to re-evaluate the feasibility and safety of using low-body-weight donors.\n\n\nMETHODS\nWe retrospectively analyzed 91 deceased donor pediatric liver transplantation between January 2014 and December 2016, donor weight less than 5\u202fkg was defined as low-body-weight donors. The recipients were divided into two groups according to donor weight. (≤5\u202fkg and 5\u202fkg\u202f<\u202fto ≤20\u202fkg). Donor and recipient characteristics, perioperative data, postoperative complications as well as graft and recipient survival rate were compared RESULTS: The recipients and grafts recovery after transplantation were comparable between two groups. The recipients receiving low-body-weight donors showed higher risk of hepatic artery thrombosis and small-for-size syndrome, however, these complications can effectively be treated by our strategies. The 2-year patient survival rates were 92.9% and 95.2%, 2-year graft survival rates were 92.9% and 93.7% in Groups 1 and 2, without significant difference.\n\n\nCONCLUSIONS\nOur finding suggested that the utility of livers from low-body-weight donors is a potential strategy to increase donor availability in well-selected pediatric recipients.\n\n\nLEVEL OF EVIDENCE\nIII.