Considerations

Operative techniques in pediatric liver transplantation have evolved significantly in the last decade. The most important advances include the techniques to reduce the size of a large donor's liver in order to transplant a portion into a small child, the procurement of grafts from living donors and the division of a liver to transplant into a child and an older recipient.2

The transplant operation itself can be divided into three phases: the removal of the native liver, the anhepatic phase during which the new organ is implanted, and the reperfusion phase.

Explant of Diseased Liver

The removal of a diseased liver in the child is often the most hazardous part of the liver transplant procedure. Much of the dissection is done with cautery to minimize bleeding or with sharp dissection with ligation of all structures that will be divided. Patients with previous Kasai operations for biliary atresia have extensive scarring in the right upper quadrant increasing the difficulty of dissection.3 After opening the abdomen, adhesions between the liver, colon, stomach and abdominal wall obscure clear entry into the abdominal cavity. The portoenterostomy

How To Reduce Acne Scarring

How To Reduce Acne Scarring

Acne is a name that is famous in its own right, but for all of the wrong reasons. Most teenagers know, and dread, the very word, as it so prevalently wrecks havoc on their faces throughout their adolescent years.

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