Living related liver transplantation in pediatrics

Abstract

Improvements in surgical techniques to exploit the segmental anatomy of the liver has provided the surgeons with a variety of possible graft types with which a failing liver can be replaced. All methods for precise partial hepatectomy depend upon control of the inflow vasculature and draining bile ducts and the outflow hepatic veins to the portion of the liver to be excised whether this be a segment, subsegment or an entire lobe. LRLT is potentially indicated in all patients who are condidates for liver transplantation, however several ethical concerns have been aroused about exposing a perfectly healthy subject to a major operation and so all candidates for LRLT must meet three major ethical requirements. A concincing need for the innovation, an acceptable risk and benefit to the participants and a satisfactory process for ensuring optimal informed consent and protecting the safety of the donor. LRLT requires both preoperative CT measurement of the segmental liver volume in donors and prediction of the standard liver volume which fits the recipient's metabolic demands.