ABCD: Arquivos Brasileiros de Cirurgia Digestiva (Dec 2016)

PEDIATRIC LIVER TRANSPLANTATION WITH EX-SITU LIVER TRANSECTION AND THE APPLICATION OF THE HUMAN FIBRINOGEN AND THROMBIN SPONGE IN THE WOUND AREA

  • Fernando Pompeu Piza VICENTINE,
  • Adriano Miziara GONZALEZ,
  • Ramiro Anthero de AZEVEDO,
  • Barbara Burza BENINI,
  • Marcelo Moura LINHARES,
  • Gaspar de Jesus LOPES-FILHO,
  • Jose Luiz MARTINS,
  • Alcides Augusto SALZEDAS-NETTO

DOI
https://doi.org/10.1590/0102-6720201600040006
Journal volume & issue
Vol. 29, no. 4
pp. 236 – 239

Abstract

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ABSTRACT Background: Surgical strategy to increase the number of liver transplants in the pediatric population is the ex-situ liver transection (reduction or split). However, it is associated with complications such as hemorrhage and leaks. The human fibrinogen and thrombin sponge is useful for improving hemostasis in liver surgery. Aim: Compare pediatric liver transplants with ex-situ liver transection (reduction or split) with or without the human fibrinogen and thrombin sponge. Methods: Was performed a prospective analysis of 21 patients submitted to liver transplantation with ex-situ liver transection with the application of the human fibrinogen and thrombin sponge in the wound area (group A) and retrospective analysis of 59 patients without the sponge (group B). Results: The characteristics of recipients and donors were similar. There were fewer reoperations due to bleeding in the wound area in group A (14.2%) compared to group B (41.7%, p=0.029). There was no difference in relation to the biliary leak (group A: 17.6%, group B: 5.1%, p=0.14). Conclusion: There was a lower number of reoperations due to bleeding of the wound area of the hepatic graft when the human fibrinogen and thrombin sponge were used.

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