LIVING-RELATED LIVER TRANSPLANTATION IN CHILDREN: THE SHIRAZ EXPERIENCE

The liver transplantation program was established at Shiraz Nemazee Hospital in 1993. Shortage of cadaver organ supply due to various social and legal issues urged us to develop a living-related liver transplantation (LRLT) program. So far 7 (6 males, 1 female) living-related liver transplantations have been performed at this center. The mean age of patients was 8.21 years (+/- 4.16), with a range of 4.5 to 14 years. Live donors (3 mothers, 2 fathers, and 1 brother) with a mean age of 30.83 years (+/- 4.11) underwent procurement of the left lateral segment without mortality or any serious morbidity. The native liver disease was idiopathic cirrhosis (1 case), biliary atresia (3 cases), Budd-Chiari syndrome (1 case), neonatal cirrhosis (l case), and cryptogenic cirrhosis (l case). Allografts were implanted using piggy-back surgical technique. Baseline immunosuppression consisted of a triple drug regimen including cyclosporine, mycophenolate mofetil and steroids. Acute graft rejection was treated with intra-venous bolus of methyl-prednisolone. Early death occurred in 2 patients due to vascular thrombosis. Biliary complication was observed in 1 patient. Five patients are alive with a normal functioning liver. In conclusion, LRLT program is promising in Iran. It can help to overcome the shortage of organs and minimize the mortality of patients in the waiting list.