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Living donor domino liver transplantation using a maple syrup urine disease donor: A case series of three children – The first report from Japan
Author(s) -
Matsunami Masatoshi,
Fukuda Akinari,
Sasaki Kengo,
Uchida Hajime,
Shigeta Takanobu,
Hirata Yoshihiro,
Kanazawa Hiroyuki,
Horikawa Reiko,
Nakazawa Atsuko,
Suzuki Tatsuya,
Mizuta Koichi,
Kasahara Mureo
Publication year - 2016
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12681
Subject(s) - medicine , domino , maple syrup urine disease , surgery , liver transplantation , transplantation , biochemistry , chemistry , leucine , amino acid , catalysis
As the priority of LD ‐Domino LT is the safety of the first recipient, limitations and technical difficulties in the second recipient often occur. The most technically challenging part of LD ‐Domino LT is the reconstruction of the vessels. For the reconstruction of HV s, the native HV s were exteriorized as far as possible using a CUSA because longer extensive HV s are essential for facilitating the reconstruction. At the back table, the HV s of the domino graft were sutured together, and the single cuff of the HV s was anastomosed to the IVC by joining the orifices. The HA s, the presence of insufficient length, and multiple vessels in the whole liver rendered the reconstruction more difficult. We determined the dividing sites of the vessels according to the preoperative 3D‐ CT findings obtained in two institutions. This is the first case series using grafts in DLT obtained from LDLT for patients with MSUD between two institutions. In conclusion, LD ‐Domino LT is a safe and feasible therapeutic option to expand the donor pool by technical refinement in the reconstruction of the second recipient. Further studies with a greater accumulation of patients and a longer follow‐up will be necessary to establish LD ‐Domino LT using an MSUD donor.