Open AccessSuccessful use of size‐mismatched liver allografts in children by delayed primary closure of the abdominal wall
Author(s) -
Soin A. S.,
Friend P. J.,
NobleJamieson G.,
Watson C. J. E.,
Jamieson N. V.,
Calne R. Y.,
Barnes N.
Publication year - 1996
Publication title -
british journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.202
H-Index - 201
eISSN - 1365-2168
pISSN - 0007-1323
DOI - 10.1002/bjs.1800831111
Subject(s) - medicine , surgery , abdominal wall , closure (psychology) , reduction (mathematics) , geometry , mathematics , economics , market economy
Children who are too ill to await a liver graft of suitable size may be transplanted with a relatively oversized graft by leaving the abdominal wound partially open, the defect being bridged with polypropylene mesh and the mesh reduced in stages until it can be removed and the wound directly closed. This technique has been used in seven children who received nine grafts (five reduced and four full size). Their mean age was 7·3 (range 0·5–11) months and mean weight 5·8 (range 2·3–7·2) kg. Progressive reduction in the size of the transplanted liver made primary closure possible in survivors in up to four stages. Over a follow‐up period of 3 to 58 months, five of the nine grafts and five of the seven patients survived. No significant complications attributable to the technique were encountered. The technique of delayed primary abdominal wall closure may be of benefit in children at risk of graft failure because of a size‐mismatched graft.