TY - JOUR
T1 - Living Donor Liver Transplantation for Acute Liver Failure
T2 - A 10-Year Experience in a Single Center
AU - Ikegami, Toru
AU - Taketomi, Akinobu
AU - Soejima, Yuji
AU - Yoshizumi, Tomoharu
AU - Sanefuji, Kensaku
AU - Kayashima, Hiroto
AU - Shimada, Mitsuo
AU - Maehara, Yoshihiko
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2008/3
Y1 - 2008/3
N2 - Background: Living donor liver transplantation has become an accepted treatment for various terminal liver diseases. Study Design: Forty-two living donor liver transplantations performed for acute liver failure during a 10-year period at Kyushu University Hospital were reviewed. Results: Causes of liver failure included hepatitis B (n = 12), hepatitis C (n = 1), autoimmune hepatitis (n = 2), Wilson's disease (n = 3), and unknown causes (n = 24). The graft types were: left lobe (n = 33), right lobe (n = 8), and lateral segment (n = 1). The mean graft volume to standard liver volume ratios were 42.2 ± 9.2% in left lobe grafts and 50.5 ± 3.9% in right lobe grafts (p < 0.05). Extubation was significantly delayed in grade IV encephalopathy patients (73.7 ± 18.2 hours) compared with patients with other grades (p < 0.01 to grades I and II, p < 0.05 to grade III). All other patients, except one with a subarachnoid hemorrhage, had complete neurologic recovery after transplantation. The 1- and 10-year survival rates were 77.6% and 65.5%, respectively, for grafts, and 80.0% and 68.2%, respectively, for patients. Conclusions: Outcomes of living donor liver transplantation for acute liver failure are fairly acceptable despite severe general conditions and emergent transplant settings. Living donor liver transplantation is now among the currently accepted life-saving treatments of choice for acute liver failure, although innovative medical treatments for this disease entity are still anticipated.
AB - Background: Living donor liver transplantation has become an accepted treatment for various terminal liver diseases. Study Design: Forty-two living donor liver transplantations performed for acute liver failure during a 10-year period at Kyushu University Hospital were reviewed. Results: Causes of liver failure included hepatitis B (n = 12), hepatitis C (n = 1), autoimmune hepatitis (n = 2), Wilson's disease (n = 3), and unknown causes (n = 24). The graft types were: left lobe (n = 33), right lobe (n = 8), and lateral segment (n = 1). The mean graft volume to standard liver volume ratios were 42.2 ± 9.2% in left lobe grafts and 50.5 ± 3.9% in right lobe grafts (p < 0.05). Extubation was significantly delayed in grade IV encephalopathy patients (73.7 ± 18.2 hours) compared with patients with other grades (p < 0.01 to grades I and II, p < 0.05 to grade III). All other patients, except one with a subarachnoid hemorrhage, had complete neurologic recovery after transplantation. The 1- and 10-year survival rates were 77.6% and 65.5%, respectively, for grafts, and 80.0% and 68.2%, respectively, for patients. Conclusions: Outcomes of living donor liver transplantation for acute liver failure are fairly acceptable despite severe general conditions and emergent transplant settings. Living donor liver transplantation is now among the currently accepted life-saving treatments of choice for acute liver failure, although innovative medical treatments for this disease entity are still anticipated.
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U2 - 10.1016/j.jamcollsurg.2007.08.018
DO - 10.1016/j.jamcollsurg.2007.08.018
M3 - Article
C2 - 18308209
AN - SCOPUS:39549093987
VL - 206
SP - 412
EP - 418
JO - Journal of the American College of Surgeons
JF - Journal of the American College of Surgeons
SN - 1072-7515
IS - 3
ER -