Kết quả bước đầu ghép gan từ người hiến sống trong điều trị u nguyên bào gan trẻ em tại Bệnh viện Nhi Trung ương

Abstract

This retrospective study describes four pediatric patients with hepatoblastoma who underwent living donor liver transplantation (LDLT) at the National Children's Hospital between May 2021 and October 2024. The patients' ages ranged from 17 to 33 months old. Baseline liver function was preserved, with PELD scores ranging from -7 to 1. The tumors were classified as POSTTEXT III–IV or had recurred following previous hepatectomy, precluding complete surgical resection. All patients received left liver lobe grafts from living related donors, with graft-to-recipient weight ratios (GRWR) ranging from 1.6% to 2.6%. The surgical procedures necessitated individualized vascular reconstruction due to anatomical complexity and small vessel calibers. Postoperatively, graft function recovered favorably, and surgical complications were effectively managed via surgical or interventional approaches. At a follow-up of 18 to 58 months, three patients remained alive and stable, whereas one patient passed on 10 months post-transplantation due to tumor recurrence and multifocal metastasis. These initial findings demonstrate the feasibility of LDLT in pediatric patients with hepatoblastoma; however, further studies with larger sample sizes and longer follow-up durations are warranted.