File Download
  Links for fulltext
     (May Require Subscription)

Article: Lessons learned from one hundred right lobe living donor liver transplants

TitleLessons learned from one hundred right lobe living donor liver transplants
Authors
Issue Date2004
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.com
Citation
Annals Of Surgery, 2004, v. 240 n. 1, p. 151-158 How to Cite?
AbstractObjective: To evaluate the first 100 adult right lobe living donor liver transplants (LDLT) in a single center to determine whether the results have improved with technical modifications and better experience. Summary Background Data: Right lobe LDLT has been increasingly performed for adults with end-stage liver disease. Numerous modifications in technique have been introduced, and a learning curve is likely in view of its complexity. Methods: One hundred consecutive adult right lobe LDLTs performed between May 1996 and May 2002 were retrospectively studied by comparing the first 50 (group 1) with the last 50 cases (group 2). The median follow-up was 37 (27 to 79) months for group 1 and 15 (7 to 27) months for group 2. Results: The characteristics of donors and liver grafts were similar. In group 2, fewer recipients were intensive care unit (ICU)-bound or had hepatorenal syndrome before transplantation, and there was a lower disease severity as shown by a lower Child-Pugh score and Model for End-Stage Liver Disease (MELD) score. Significant improvements were found in the operation time, blood loss, ICU stay, and postoperative complication rate of the donors and in the operation time, transfusion requirements, number of reoperations, ICU stay, and hospital stay of the recipients in group 2. The hospital mortality rate of recipients was reduced from 16% to 0% (P = 0.006). Graft survival rates at 12 months and 24 months were improved from 80% and 74%, respectively, in group 1 to 100% and 96%, respectively, in group 2 (P = 0.002). After adjusting for differences in recipient risk factors (ICU-bound, hepatorenal syndrome, Child-Pugh score, and MELD score) in a multivariate Cox model, recipients in group 2 had significantly lower risk of graft loss (relative risk compared with group 1, 0.13; 95% CI, 0.03 to 0.66; P = 0.014). Conclusions: There is a learning curve in adult right lobe LDLT. The results have significantly improved with technical refinement and better experience.
Persistent Identifierhttp://hdl.handle.net/10722/48944
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.authorLiu, CLen_HK
dc.contributor.authorYong, BHen_HK
dc.contributor.authorWong, Yen_HK
dc.contributor.authorLau, GKen_HK
dc.contributor.authorLai, CLen_HK
dc.contributor.authorNg, IOen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2008-06-12T06:30:19Z-
dc.date.available2008-06-12T06:30:19Z-
dc.date.issued2004en_HK
dc.identifier.citationAnnals Of Surgery, 2004, v. 240 n. 1, p. 151-158en_HK
dc.identifier.issn0003-4932en_HK
dc.identifier.urihttp://hdl.handle.net/10722/48944-
dc.description.abstractObjective: To evaluate the first 100 adult right lobe living donor liver transplants (LDLT) in a single center to determine whether the results have improved with technical modifications and better experience. Summary Background Data: Right lobe LDLT has been increasingly performed for adults with end-stage liver disease. Numerous modifications in technique have been introduced, and a learning curve is likely in view of its complexity. Methods: One hundred consecutive adult right lobe LDLTs performed between May 1996 and May 2002 were retrospectively studied by comparing the first 50 (group 1) with the last 50 cases (group 2). The median follow-up was 37 (27 to 79) months for group 1 and 15 (7 to 27) months for group 2. Results: The characteristics of donors and liver grafts were similar. In group 2, fewer recipients were intensive care unit (ICU)-bound or had hepatorenal syndrome before transplantation, and there was a lower disease severity as shown by a lower Child-Pugh score and Model for End-Stage Liver Disease (MELD) score. Significant improvements were found in the operation time, blood loss, ICU stay, and postoperative complication rate of the donors and in the operation time, transfusion requirements, number of reoperations, ICU stay, and hospital stay of the recipients in group 2. The hospital mortality rate of recipients was reduced from 16% to 0% (P = 0.006). Graft survival rates at 12 months and 24 months were improved from 80% and 74%, respectively, in group 1 to 100% and 96%, respectively, in group 2 (P = 0.002). After adjusting for differences in recipient risk factors (ICU-bound, hepatorenal syndrome, Child-Pugh score, and MELD score) in a multivariate Cox model, recipients in group 2 had significantly lower risk of graft loss (relative risk compared with group 1, 0.13; 95% CI, 0.03 to 0.66; P = 0.014). Conclusions: There is a learning curve in adult right lobe LDLT. The results have significantly improved with technical refinement and better experience.en_HK
dc.format.extent388 bytes-
dc.format.mimetypetext/html-
dc.languageengen_HK
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.comen_HK
dc.relation.ispartofAnnals of Surgeryen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshLiver Transplantation - adverse effects - methodsen_HK
dc.subject.meshLiving Donorsen_HK
dc.subject.meshGraft Survivalen_HK
dc.subject.meshLiver - radiographyen_HK
dc.subject.meshPostoperative Complicationsen_HK
dc.titleLessons learned from one hundred right lobe living donor liver transplantsen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0003-4932&volume=240&issue=1&spage=151&epage=158&date=2004&atitle=Lessons+learned+from+one+hundred+right+lobe+living+donor+liver+transplantsen_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailLai, CL: hrmelcl@hku.hken_HK
dc.identifier.emailNg, IO: 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.authorityLai, CL=rp00314en_HK
dc.identifier.authorityNg, IO=rp00335en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.doi10.1097/01.sla.0000129340.05238.a0en_HK
dc.identifier.pmid15213631-
dc.identifier.pmcidPMC1356387en_HK
dc.identifier.scopuseid_2-s2.0-3042519295en_HK
dc.identifier.hkuros90702-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-3042519295&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume240en_HK
dc.identifier.issue1en_HK
dc.identifier.spage151en_HK
dc.identifier.epage158en_HK
dc.identifier.isiWOS:000222280000022-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridLiu, CL=7409789712en_HK
dc.identifier.scopusauthoridYong, BH=7003644314en_HK
dc.identifier.scopusauthoridWong, Y=7403041884en_HK
dc.identifier.scopusauthoridLau, GK=7102301257en_HK
dc.identifier.scopusauthoridLai, CL=7403086396en_HK
dc.identifier.scopusauthoridNg, IO=7102753722en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats