Negative wound therapy to manage large-for-size liver graft mismatch

Clin Res Hepatol Gastroenterol. 2015 Oct;39(5):552-4. doi: 10.1016/j.clinre.2015.02.009. Epub 2015 Jun 20.

Abstract

Liver volume matching in liver transplantation (LT) is of paramount importance. There is no agreement for its definition, ranging from a graft-to-recipient-weight-ratio greater than 4% in paediatric to less than 2.5% in adult LT. Advances have been obtained to avoid small for size grafts, but management of large grafts remains a major challenge in this setting. Consequences include difficult anastomosis, poor vascular alignment, difficult wound closure, graft compression and necrosis. We report on two patients who underwent LT with large grafts and develop major liver graft injury. Technical solutions used in these two cases are presented and discussed. Negative wound therapy allowed a rapid closure of abdominal wall and salvage of the graft.

Publication types

  • Case Reports

MeSH terms

  • Abdomen / surgery*
  • Adult
  • Body Surface Area*
  • Cholangitis, Sclerosing / surgery
  • Female
  • Graft Survival*
  • Hepatitis B / surgery
  • Humans
  • Liver Transplantation* / methods
  • Middle Aged
  • Negative-Pressure Wound Therapy* / methods
  • Organ Size*
  • Treatment Outcome
  • Wound Healing*