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Graft reduction using a powered stapler in pediatric living donor liver transplantation
Author(s) -
Yoshimaru Koichiro,
Matsuura Toshiharu,
Kinoshita Yoshiaki,
Hayashida Makoto,
Takahashi Yoshiaki,
Yanagi Yusuke,
Harimoto Norifumi,
Ikegami Toru,
Uchiyama Hideaki,
Yoshizumi Tomoharu,
Maehara Yoshihiko,
Taguchi Tomoaki
Publication year - 2017
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.12985
Subject(s) - medicine , surgery , reduction (mathematics) , liver transplantation , transplantation , geometry , mathematics
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.