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First paediatric live donor liver transplant in Sri Lanka with 1 year outcome : challenges for the future

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dc.contributor.author Siriwardana, R.
dc.contributor.author Thilakarathne, S.
dc.contributor.author Fernando, M.
dc.contributor.author Gunetilleke, M.B.
dc.contributor.author Weerasooriya, A.
dc.contributor.author Appuhamy, C.
dc.date.accessioned 2022-01-13T04:41:37Z
dc.date.available 2022-01-13T04:41:37Z
dc.date.issued 2021
dc.identifier.citation Sri Lanka Journal of Surgery. 2021;39(3):33–5. en_US
dc.identifier.issn 2279-2201
dc.identifier.uri http://repository.kln.ac.lk/handle/123456789/24331
dc.description.abstract INTRODUCTION: Liver transplantation in the paediatric age group is demanding due to smaller body proportions and physiology. This paper describes the first successful paediatric liver transplant in Sri Lanka along with its one-year outcome. Describing the challenges faced during the process, we highlight the factors that need to be considered for a sustainable programme in the future. METHODOLOGY: A 9-year-old girl who had progressive familial intra hepatic cholestasis type 3 was referred to us with features of end stage liver disease. She was identified as a suitable candidate for liver transplantation. Her 38-year-old mother was selected as the donor, who was evaluated for suitability of a left lateral segment donation. RESULTS: The first paediatric liver transplantation was performed in July 2020. The child's mother donated the left lateral segment weighing 325g. During the postoperative period the child developed outflow tract obstruction at the hepatic venous anastomosis. This was managed with a percutaneously placed stent. Six months after transplant, she developed an acute rejection that required steroids. Treatment of rejection was complicated with multiple liver abscesses caused byAspergillus. The infection was treated with systemic antifungals and drainage. At one-year post transplant, the recipient had recovered from the trauma of surgery and had normal liver biochemistry, a patent hepatic venous stented anastomosis and complete resolution of the abscesses. We faced dual challenges in dealing with a live liver transplant donor and a young child who was the recipient. Our success, on this occasion, was underscored by the multidisciplinary contribution from specialists scattered across the island combined with state-public partnership. CONCLUSION: To offer a sustainable live donor liver transplant service for the future, many other aspects, beyond surgery itself, need to be addressed. en_US
dc.language.iso en en_US
dc.publisher The College of Surgeons of Sri Lanka en_US
dc.subject Liver transplantation en_US
dc.subject Child en_US
dc.subject live-donor en_US
dc.title First paediatric live donor liver transplant in Sri Lanka with 1 year outcome : challenges for the future en_US
dc.type Article en_US


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