Ann Surg 1988 Oct;208(4):410-20

Liver transplantation, including the concept of reduced-size liver transplant
in children

Broelsch CE, Emond JC, Thistlethwaite JR, Whitington PF, Zucker AR, Baker AL,
Aran PF, Rouch DA, Lichtor JL

Abstract
Since the establishment of a clinical program in liver transplantation in 1984,
162 liver transplants have been performed in 131 patients (78 adults, 53
children). The patient mortality rate while waiting for a suitable organ has
been 8% for adults and only 4% for children (25-46% reported in the literature).
The low pediatric mortality is a result of the use of reduced-size liver
transplants. A total of 14 procedures have been performed in recipients whose
clinical condition was deteriorating and for whom no full-size graft could be
located. Of 14 children, 13 were less than 3 years of age. Patient survival is
50%, comparable to survival of high-risk recipients of full-size livers. Using
reduced-size liver grafting in a transplant program can lower mortality for
children awaiting a transplant by overcoming size disparity. Reduced-size liver
grafting will allow more effective use of donor resources and provide a
potential avenue of research for organ splitting and living related donation