Pediatric Liver Transplantation With Ex-Situ Liver Transection And The Application Of The Human Fibrinogen And Thrombin Sponge In The Wound Area

• Autor(a) principal: Vicentine, Fernando Pompeu Piza [UNIFESP]
• Data de Publicação: 2016
• Outros Autores: Gonzalez, Adriano Miziara [UNIFESP], Azevedo, Ramiro Anthero de [UNIFESP], Benini, Barbara Burza [UNIFESP], Linhares, Marcelo Moura [UNIFESP], Lopes Filho, Gaspar de Jesus [UNIFESP], Martins, Jose Luiz [UNIFESP], Salzedas-Netto, Alcides Augusto [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por; eng
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/0102-6720201600040006; https://repositorio.unifesp.br/handle/11600/56940
• topic: Liver transplantation; Hemostasis; Hepatectomy; Techniques; Transplante de fígado; Hemostasia; Hepatectomia; Técnicas

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.