Hyperreduced left lateral living donor liver transplant in a 4.5 kg child—A first in Africa

Abstract

AbstractBackgroundSupply–demand mismatch in solid organ transplantation is particularly pronounced in small children. For liver transplantation, advanced surgical techniques for reducing deceased and living donor grafts allow access to life‐saving transplantation. Living donor left lateral segment liver grafts have been successfully transplanted in small children in our center since 2013, the only program providing this service in Sub‐Saharan Africa. This type of partial graft remains too large for children below 6 kg body weight and generally requires reduction.MethodsA left lateral segment graft was reduced in situ from a directed, altruistic living donor to yield a hyperreduced left lateral segment graft.ResultsThe donor was discharged after 6 days without complications. The recipient suffered no technical surgical complications except for an infected cut‐surface biloma and biliary anastomotic stricture and remains well 9 months post‐transplant.ConclusionsWe report the first known case in Africa of a hyperreduced left lateral segment, ABO incompatible, living donor liver transplant in a 4,5 kg child with pediatric acute liver failure (PALF).