Pediatric Age-Specific Aspects of Retrieval and Bench Surgery

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

For transplantation in children, the general rules for donor selection, logistical aspects and surgical techniques as used for adults apply, but there are several age-specific aspects particular to procuring and preparing grafts from or for small-weight recipients. Donor age accepted range is from 1 to 50 years of age, but this can be extended at both ends of the spectrum (from 6 months of age up to 55 to 60-years old) when the donor characteristics are excellent or when the recipient condition is relatively urgent. The selection of donors and the search for fewer risk factors are key when reduction or split techniques are used, since the process of dividing organs is in itself an added risk (trauma and possible prolongation of ischemia). An 'optimal' donor is defined based on age, hemodynamic characteristics and systemic risk factors. In pediatric donors, preference is given to the 'no-touch' technique and aortic-only perfusion for procuring organs from the donor, particularly when the donor is not hemodinamically stable. In-situ prolonged dissection (as for in-situ liver splitting) is performed only in optimal and stable donors. Rapid techniques are preferred for multiorgan graft preparation and retrieval (as in en-bloc liver-intestine grafts).

Original languageEnglish
Title of host publicationAbdominal Organ Retrieval and Transplantation Bench Surgery
PublisherJohn Wiley and Sons
Pages155-176
Number of pages22
ISBN (Print)9780470657867
DOIs
Publication statusPublished - Apr 3 2013

Keywords

  • Children
  • Innovative techniques
  • Intestine
  • Kidney
  • Liver
  • Organ transplantation
  • Postmortem donation
  • Procurement techniques

ASJC Scopus subject areas

  • Medicine(all)

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