Living-donor liver transplantation for fulminant hepatic failure in adult patients with a left-lobe graft

Takashi Nishizaki, Shoji Hiroshige, Toru Ikegami, Hideaki Uchiyama, Koji Hashimoto, Yuji Soejima, Mitsuo Shimada

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background. Living donors are practically the only source of organs in countries where the availability of cadaveric donors is severely restricted, such as Japan. A left-lobe graft, in which one third of the liver is donated, is therefore used for adult-to-adult living-donor liver transplantation (LDLT) in patients with fulminant hepatic failure (FHF). Methods. Fifteen adult patients with FHF, ranging from 22 to 59 years of age, were treated with LDLT with a left-lobe graft. Preoperative encephalopathy was grade II in 2 patients, grade III in 4 patients, and grade IV in 9 patients. The graft volume (GV) ranged from 260 to 570 mL, thus corresponding to 23% to 54% of the recipients' standard liver volume (SLV). The patients were divided into 2 groups according to their GV/SLV: a medium-size graft group (GV/SLV≥30%; group M, n = 11) and a small-size graft group (GV/SLV <30%; group S, n = 4). The effects of GV/SLV on graft function and survival were compared. Postoperative neurologic complications were also evaluated. Results. The donors are all doing well. Twelve (80%) of the 15 recipients are still alive, with a follow-up period of from 3 to 43 months. No statistically significant differences were observed in the postoperative serum levels of bilirubin and alanine aminotransferase, prothrombin time, or frequency of postoperative complications between the 2 groups. The graft and patient survival rates were 75% (3/4) and 75% (3/4) in group S and 73% (8/11) and 82% (9/11) in group M, respectively. All patients who survived the perioperative period recovered without any neurologic sequelae. Conclusions. The high success rate and low donor risk of LDLT may therefore justify its use for adult patients with FHF using a left-lobe graft.

Original languageEnglish
Pages (from-to)S182-S189
JournalSurgery
Volume131
Issue number1
DOIs
Publication statusPublished - Jan 1 2002

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Acute Liver Failure
Living Donors
Liver Transplantation
Transplants
Liver
Tissue Donors
Graft Survival
Nervous System
Perioperative Period
Prothrombin Time
Brain Diseases
Alanine Transaminase
Bilirubin
Japan
Survival Rate

All Science Journal Classification (ASJC) codes

  • Surgery

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Living-donor liver transplantation for fulminant hepatic failure in adult patients with a left-lobe graft. / Nishizaki, Takashi; Hiroshige, Shoji; Ikegami, Toru; Uchiyama, Hideaki; Hashimoto, Koji; Soejima, Yuji; Shimada, Mitsuo.

In: Surgery, Vol. 131, No. 1, 01.01.2002, p. S182-S189.

Research output: Contribution to journalArticle

Nishizaki, Takashi ; Hiroshige, Shoji ; Ikegami, Toru ; Uchiyama, Hideaki ; Hashimoto, Koji ; Soejima, Yuji ; Shimada, Mitsuo. / Living-donor liver transplantation for fulminant hepatic failure in adult patients with a left-lobe graft. In: Surgery. 2002 ; Vol. 131, No. 1. pp. S182-S189.
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abstract = "Background. Living donors are practically the only source of organs in countries where the availability of cadaveric donors is severely restricted, such as Japan. A left-lobe graft, in which one third of the liver is donated, is therefore used for adult-to-adult living-donor liver transplantation (LDLT) in patients with fulminant hepatic failure (FHF). Methods. Fifteen adult patients with FHF, ranging from 22 to 59 years of age, were treated with LDLT with a left-lobe graft. Preoperative encephalopathy was grade II in 2 patients, grade III in 4 patients, and grade IV in 9 patients. The graft volume (GV) ranged from 260 to 570 mL, thus corresponding to 23{\%} to 54{\%} of the recipients' standard liver volume (SLV). The patients were divided into 2 groups according to their GV/SLV: a medium-size graft group (GV/SLV≥30{\%}; group M, n = 11) and a small-size graft group (GV/SLV <30{\%}; group S, n = 4). The effects of GV/SLV on graft function and survival were compared. Postoperative neurologic complications were also evaluated. Results. The donors are all doing well. Twelve (80{\%}) of the 15 recipients are still alive, with a follow-up period of from 3 to 43 months. No statistically significant differences were observed in the postoperative serum levels of bilirubin and alanine aminotransferase, prothrombin time, or frequency of postoperative complications between the 2 groups. The graft and patient survival rates were 75{\%} (3/4) and 75{\%} (3/4) in group S and 73{\%} (8/11) and 82{\%} (9/11) in group M, respectively. All patients who survived the perioperative period recovered without any neurologic sequelae. Conclusions. The high success rate and low donor risk of LDLT may therefore justify its use for adult patients with FHF using a left-lobe graft.",
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T1 - Living-donor liver transplantation for fulminant hepatic failure in adult patients with a left-lobe graft

AU - Nishizaki, Takashi

AU - Hiroshige, Shoji

AU - Ikegami, Toru

AU - Uchiyama, Hideaki

AU - Hashimoto, Koji

AU - Soejima, Yuji

AU - Shimada, Mitsuo

PY - 2002/1/1

Y1 - 2002/1/1

N2 - Background. Living donors are practically the only source of organs in countries where the availability of cadaveric donors is severely restricted, such as Japan. A left-lobe graft, in which one third of the liver is donated, is therefore used for adult-to-adult living-donor liver transplantation (LDLT) in patients with fulminant hepatic failure (FHF). Methods. Fifteen adult patients with FHF, ranging from 22 to 59 years of age, were treated with LDLT with a left-lobe graft. Preoperative encephalopathy was grade II in 2 patients, grade III in 4 patients, and grade IV in 9 patients. The graft volume (GV) ranged from 260 to 570 mL, thus corresponding to 23% to 54% of the recipients' standard liver volume (SLV). The patients were divided into 2 groups according to their GV/SLV: a medium-size graft group (GV/SLV≥30%; group M, n = 11) and a small-size graft group (GV/SLV <30%; group S, n = 4). The effects of GV/SLV on graft function and survival were compared. Postoperative neurologic complications were also evaluated. Results. The donors are all doing well. Twelve (80%) of the 15 recipients are still alive, with a follow-up period of from 3 to 43 months. No statistically significant differences were observed in the postoperative serum levels of bilirubin and alanine aminotransferase, prothrombin time, or frequency of postoperative complications between the 2 groups. The graft and patient survival rates were 75% (3/4) and 75% (3/4) in group S and 73% (8/11) and 82% (9/11) in group M, respectively. All patients who survived the perioperative period recovered without any neurologic sequelae. Conclusions. The high success rate and low donor risk of LDLT may therefore justify its use for adult patients with FHF using a left-lobe graft.

AB - Background. Living donors are practically the only source of organs in countries where the availability of cadaveric donors is severely restricted, such as Japan. A left-lobe graft, in which one third of the liver is donated, is therefore used for adult-to-adult living-donor liver transplantation (LDLT) in patients with fulminant hepatic failure (FHF). Methods. Fifteen adult patients with FHF, ranging from 22 to 59 years of age, were treated with LDLT with a left-lobe graft. Preoperative encephalopathy was grade II in 2 patients, grade III in 4 patients, and grade IV in 9 patients. The graft volume (GV) ranged from 260 to 570 mL, thus corresponding to 23% to 54% of the recipients' standard liver volume (SLV). The patients were divided into 2 groups according to their GV/SLV: a medium-size graft group (GV/SLV≥30%; group M, n = 11) and a small-size graft group (GV/SLV <30%; group S, n = 4). The effects of GV/SLV on graft function and survival were compared. Postoperative neurologic complications were also evaluated. Results. The donors are all doing well. Twelve (80%) of the 15 recipients are still alive, with a follow-up period of from 3 to 43 months. No statistically significant differences were observed in the postoperative serum levels of bilirubin and alanine aminotransferase, prothrombin time, or frequency of postoperative complications between the 2 groups. The graft and patient survival rates were 75% (3/4) and 75% (3/4) in group S and 73% (8/11) and 82% (9/11) in group M, respectively. All patients who survived the perioperative period recovered without any neurologic sequelae. Conclusions. The high success rate and low donor risk of LDLT may therefore justify its use for adult patients with FHF using a left-lobe graft.

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