Kết quả bước đầu ghép gan trẻ em từ người hiến chết não: Báo cáo loạt ca bệnh tại Bệnh viện Nhi Trung ương

Abstract

This retrospective descriptive study reports 5 cases of pediatric deceased donor liver transplantation (DDLT) performed at the Vietnam National Children's Hospital (age range: 8 - 48 months). During the organ procurement process, the cold ischemia time ranged from 40 minutes to 7 hours. To manage complex variations, surgeons applied various individualized advanced techniques, including graft volume reduction, oblique spatulation or confluence anastomosis of the portal vein, common orifice plasty for multiple bile ducts with stenting, splenic artery ligation, and delayed abdominal closure. Early outcomes over a mean follow-up period of 3.6 months revealed no instances of biliary leakage or portal vein thrombosis. However, one case developed hepatic artery stenosis and acute rejection at 3 months post-transplantation, which was managed with endovascular intervention and an ongoing optimized immunosuppressive regimen. These preliminary findings demonstrate the surgical feasibility and safety of pediatric DDLT in the short-term follow-up; nevertheless, further studies with larger sample sizes and extended follow-up periods are warranted.