Delayed primary closure of the abdominal wall after cadaveric and living related donor liver graft transplantation in children: a safe and useful technique |
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Authors: | J de Ville de Goyet Y Struye de Swielande R Reding E M Sokal J B Otte |
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Institution: | (1) Pediatric Liver Transplant Unit, Department of Pediatric Surgery, University Hospital Saint-luc, Avenue Hippocrate 10, B-1200 Brussels, Belgium, BE;(2) Department of Pediatrics, University Hospital Saint-luc, Avenue Hippocrate 10, B-1200 Brussels, Belgium, BE |
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Abstract: | Due to the shortage of size-matched liver donors, relatively oversized liver grafts (even after ex situ volume reduction)
are frequently used for liver transplantation in children. This was recently observed when livers from large, living related
donors were procured for transplantation in very small recipients. Given that abdominal hyperpressure can compromise vascular
flow in the new graft, primary closure of the abdomen was delayed by temporary Silastic prosthetic closure in selected cases.
The new technique was original in that the skin was closed, avoiding fluid loss and reducing the risk of infections reported
with other techniques, and in that reoperation allowed for a delayed, but primary-type, closure (fascia and skin) that resulted
in an esthetically correct aspect. Over a period of 7 years, 330 pediatric liver transplantations were performed, and delayed
prosthetic closure was achieved successfully and safely in 47 cases. The present report outlines this clinical experience.
Received: 26 May 1997 Received after revision: 14 October 1997 Accepted: 19 November 1997 |
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Keywords: | Pediatric liver transplantation abdominal wall prosthesis Abdominal wall pediatric liver transplantation prosthesis Prosthesis pediatric liver transplantation abdominal wall |
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