Abstract
In general, pediatric facilities often experience difficulty handling adult hospitalizations, examinations, and surgeries due to their history and characteristics. In pediatric living-donor liver transplantation requiring an adult donor, "ingenuity" in terms of hardware and software is required in pediatric facilities. Most pediatric liver transplants in Japan are currently performed at university hospitals, and only three pediatric hospitals in Japan, including our own hospital, are performing liver transplantation. Until 2019, there were 11 facilities nationwide that had performed pediatric liver transplantation for more than 50 cases in the past and for 5 or more cases in the past 3 years. Nine of these were university hospitals, and the remaining two were pediatric hospitals, including our hospital. We started the first pediatric liver transplant program in Saitama Prefecture in September 2019, and donors were hospitalized and operated on at the adjacent Saitama Red Cross Hospital. A key characteristic of our hospital is that many incompatible living donor transplants are performed. As the pediatric cancer base hospital with the largest number of pediatric cancer registrations in Japan, pediatric solid tumor cases represented by hepatoblastoma, and other rare tumors are introduced to us. Professional and systematic cooperation between medical teams is very easy to maintain in pediatric facilities, but the management and cooperation of adult donors has been a problem. Our facility might provide a model case for liver transplantation in pediatric hospitals nationwide.
