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Article: Adult-to-adult living donor liver transplantation using extended right lobe grafts

TitleAdult-to-adult living donor liver transplantation using extended right lobe grafts
Authors
Issue Date1997
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.com
Citation
Annals Of Surgery, 1997, v. 226 n. 3, p. 261-270 How to Cite?
AbstractObjective: The authors report their experience with living donor liver transplantation (LDLT) using extended right lobe grafts for adult patients under high-urgency situations. Summary Background Data: The efficacy of LDLT in the treatment of children has been established. The major limitation of adult-to-adult LDLT is the adequacy of the graft size. A left lobe graft from a relatively small volunteer donor will not meet the metabolic demand of a larger recipient. Methods: From May 1996 to November 1996, seven LDLTs, using extended right lobe grafts, were performed under high-urgency situations. All recipients were in intensive care units before transplantation with five having acute renal failure, three on mechanical ventilation, and all with hepatic encephalopathy. The median body weight for the donors and recipients was 58 kg (range, 41-84 kg) and 65 kg (range, 53-90 kg), respectively. The body weights of four donors were less than those of the corresponding recipients, and the lowest donor-to-recipient body weight ratio was 0.62:1. The extended right lobe graft was chosen because the left lobe volume was <40% of the ideal liver mass of the recipient. Results: Median blood loss for the donors was 900 mL (range, 700-1600 mL) and hospital stay was 19 days (range, 8-22 days). Homologous blood transfusion was not required. Two donors had complications (one incisional hernia and one bile duct stricture) requiring reoperation after discharge. All were well with normal liver function 5 to 10 months after surgery. The graft weight ranged from 490 g to 1140 g. All grafts showed immediate function with normalization of prothrombin time and recovery of conscious state of the recipients. There was no vascular complication, but six recipients required reoperation. One recipient died of systemic candidiasis 16 days after transplantation and 6 (66%) were alive with the original graft at a median follow-up of 6.5 months (range, 5-10 months). Conclusions: When performed by a team with experience in hepatectomy and transplantation, LDLT, using an extended right lobe graft, can achieve superior results. The technique extends the success of LDLT from pediatric recipients to adult recipients and opens a new donor pool for adults to receive a timely graft of adequate function.
Persistent Identifierhttp://hdl.handle.net/10722/148095
ISSN
2015 Impact Factor: 8.569
2015 SCImago Journal Rankings: 4.503
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLo, CMen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorUu, CLen_HK
dc.contributor.authorWei, WIen_HK
dc.contributor.authorLo, RJWen_HK
dc.contributor.authorLai, CLen_HK
dc.contributor.authorChan, JKFen_HK
dc.contributor.authorNg, IOLen_HK
dc.contributor.authorFung, Aen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2012-05-29T06:10:48Z-
dc.date.available2012-05-29T06:10:48Z-
dc.date.issued1997en_HK
dc.identifier.citationAnnals Of Surgery, 1997, v. 226 n. 3, p. 261-270en_HK
dc.identifier.issn0003-4932en_HK
dc.identifier.urihttp://hdl.handle.net/10722/148095-
dc.description.abstractObjective: The authors report their experience with living donor liver transplantation (LDLT) using extended right lobe grafts for adult patients under high-urgency situations. Summary Background Data: The efficacy of LDLT in the treatment of children has been established. The major limitation of adult-to-adult LDLT is the adequacy of the graft size. A left lobe graft from a relatively small volunteer donor will not meet the metabolic demand of a larger recipient. Methods: From May 1996 to November 1996, seven LDLTs, using extended right lobe grafts, were performed under high-urgency situations. All recipients were in intensive care units before transplantation with five having acute renal failure, three on mechanical ventilation, and all with hepatic encephalopathy. The median body weight for the donors and recipients was 58 kg (range, 41-84 kg) and 65 kg (range, 53-90 kg), respectively. The body weights of four donors were less than those of the corresponding recipients, and the lowest donor-to-recipient body weight ratio was 0.62:1. The extended right lobe graft was chosen because the left lobe volume was <40% of the ideal liver mass of the recipient. Results: Median blood loss for the donors was 900 mL (range, 700-1600 mL) and hospital stay was 19 days (range, 8-22 days). Homologous blood transfusion was not required. Two donors had complications (one incisional hernia and one bile duct stricture) requiring reoperation after discharge. All were well with normal liver function 5 to 10 months after surgery. The graft weight ranged from 490 g to 1140 g. All grafts showed immediate function with normalization of prothrombin time and recovery of conscious state of the recipients. There was no vascular complication, but six recipients required reoperation. One recipient died of systemic candidiasis 16 days after transplantation and 6 (66%) were alive with the original graft at a median follow-up of 6.5 months (range, 5-10 months). Conclusions: When performed by a team with experience in hepatectomy and transplantation, LDLT, using an extended right lobe graft, can achieve superior results. The technique extends the success of LDLT from pediatric recipients to adult recipients and opens a new donor pool for adults to receive a timely graft of adequate function.en_HK
dc.languageengen_US
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.comen_HK
dc.relation.ispartofAnnals of Surgeryen_HK
dc.rightsAnnals of Surgery. Copyright © Lippincott Williams & Wilkins.-
dc.subject.meshAcute Kidney Injury - Surgeryen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshBlood Loss, Surgicalen_US
dc.subject.meshBody Weighten_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHumansen_US
dc.subject.meshInformed Consenten_US
dc.subject.meshLength Of Stayen_US
dc.subject.meshLiver - Pathology - Ultrasonographyen_US
dc.subject.meshLiver Function Testsen_US
dc.subject.meshLiver Transplantation - Adverse Effectsen_US
dc.subject.meshLiving Donorsen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshOrgan Sizeen_US
dc.subject.meshPostoperative Careen_US
dc.subject.meshReoperationen_US
dc.titleAdult-to-adult living donor liver transplantation using extended right lobe graftsen_HK
dc.typeArticleen_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailWei, WI: hrmswwi@hku.hken_HK
dc.identifier.emailLai, CL: hrmelcl@hku.hken_HK
dc.identifier.emailNg, IOL: iolng@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityWei, WI=rp00323en_HK
dc.identifier.authorityLai, CL=rp00314en_HK
dc.identifier.authorityNg, IOL=rp00335en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_OA_fulltexten_US
dc.identifier.doi10.1097/00000658-199709000-00005en_HK
dc.identifier.pmid9339932-
dc.identifier.pmcidPMC1191019-
dc.identifier.scopuseid_2-s2.0-0031418731en_HK
dc.identifier.hkuros28768-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0031418731&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume226en_HK
dc.identifier.issue3en_HK
dc.identifier.spage261en_HK
dc.identifier.epage270en_HK
dc.identifier.isiWOS:A1997YA43300026-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridUu, CL=15038968800en_HK
dc.identifier.scopusauthoridWei, WI=7403321552en_HK
dc.identifier.scopusauthoridLo, RJW=7102109593en_HK
dc.identifier.scopusauthoridLai, CL=7403086396en_HK
dc.identifier.scopusauthoridChan, JKF=7403287057en_HK
dc.identifier.scopusauthoridNg, IOL=7102753722en_HK
dc.identifier.scopusauthoridFung, A=8728678800en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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