Ann Surg 1990 Feb;211(2):146-57

Size reduction of the donor liver is a safe way to alleviate the shortage o
size-matched organs in pediatric liver transplantation

Otte JB, de Ville de Goyet J, Sokal E, Alberti D, Moulin D, de Hemptinne B,
Veyckemans F, van Obbergh L, Carlier M, Clapuyt P, et al

Abstract
The development of pediatric liver transplantation is considerably hampered by
the dire shortage of small donor organs. This is a very sad situation because in
most experienced centers, liver replacement can offer a long-term hope of
survival of more than 70% in a growing variety of pediatric liver disorders. The
reported experience with 54 reduced-size grafts on a total of 141 transplants
performed in 117 children between 1984 and 1988 demonstrates that the technique
of reduced-size liver transplantation not only allows long-term survival but, in
fact, offers the same survival hope with the same quality of liver function,
regardless of the child's age and clinical condition. The prominent feature of
our experience with the reduced liver concerns its deliberate use for elective
cases. Seventy-seven per cent of the 30 children who electively received a
reduced liver were alive 1 year after transplantation, as were 85% of the 62
children who received a full-size graft. There is no difference in the long-term
survival rate of patients who received elective grafts, which is in the range of
75% with both techniques