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Article: A decade of right liver adult-to-adult living donor liver transplantation: The recipient mid-term outcomes

TitleA decade of right liver adult-to-adult living donor liver transplantation: The recipient mid-term outcomes
Authors
Issue Date2008
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.com
Citation
Annals Of Surgery, 2008, v. 248 n. 3, p. 411-418 How to Cite?
AbstractObjective: We analyzed a single centers experience over a decade of right liver living donor liver transplantation (RLDLT). Summary Background Data: To define the donor risk and recipient benefit ratio, midterm outcome of this life-saving treatment modality ought to be known. Methods: Consecutive patients from 9 May 1996 were included. Era I comprised the first 50 patients and Era II comprised the remaining 184 patients. Their midterm outcomes were compared with patients receiving deceased donor liver transplantation (DDLT) of the same period in the same center. Results: With a median follow-up of 48 months, the 1-, 3-, and 5-year overall survival rates were 93.2%, 85.7%, and 82.4%, respectively and were comparable with those of DDLT (n = 131) (90.1%, 87.7%, and 85.2%) (P = 0.876). Hospital mortality decreased from 16% in Era I to 2.2% in Era II (P = 0.000). Reduced hospital mortality improved the overall survival rates from Era I to Era II (78%, 74%, and 72% vs. 97.3%, 88.7%, and 85.1%, respectively) (P = 0.003). The 5-year survival rate of recipients with hepatocellular carcinoma (HCC) (n = 65) was 65.7%. Starting from Era II, excellent 5-year survival of recipients without HCC was achieved as compared with DDLT in the same period (93.4% vs. 88.2%) (P = 0.493). The 5-year survival rates of recipients with HCC within the Milan criteria of Era II and DDLT in the same period were 72.0% and 100%, respectively (P = 0.091). Multivariate analysis indicated that only Era I (relative risk = 2.606; P = 0.005) and pretransplant HCC (relative risk = 2.729; P = 0.002) adversely affected overall survival. Conclusions: High midterm survivals were achieved by reduction of hospital mortality through accumulation of experience and transplanting recipients with low chance of recurrence of HCC. RLDLT could be considered as a legitimate alternative to DDLT. © 2008 Lippincott Williams & Wilkins.
Persistent Identifierhttp://hdl.handle.net/10722/59992
ISSN
2015 Impact Factor: 8.569
2015 SCImago Journal Rankings: 4.503
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChan, SCen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorLo, CMen_HK
dc.contributor.authorLiu, CLen_HK
dc.contributor.authorWei, WIen_HK
dc.contributor.authorChik, BHYen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-05-31T04:01:33Z-
dc.date.available2010-05-31T04:01:33Z-
dc.date.issued2008en_HK
dc.identifier.citationAnnals Of Surgery, 2008, v. 248 n. 3, p. 411-418en_HK
dc.identifier.issn0003-4932en_HK
dc.identifier.urihttp://hdl.handle.net/10722/59992-
dc.description.abstractObjective: We analyzed a single centers experience over a decade of right liver living donor liver transplantation (RLDLT). Summary Background Data: To define the donor risk and recipient benefit ratio, midterm outcome of this life-saving treatment modality ought to be known. Methods: Consecutive patients from 9 May 1996 were included. Era I comprised the first 50 patients and Era II comprised the remaining 184 patients. Their midterm outcomes were compared with patients receiving deceased donor liver transplantation (DDLT) of the same period in the same center. Results: With a median follow-up of 48 months, the 1-, 3-, and 5-year overall survival rates were 93.2%, 85.7%, and 82.4%, respectively and were comparable with those of DDLT (n = 131) (90.1%, 87.7%, and 85.2%) (P = 0.876). Hospital mortality decreased from 16% in Era I to 2.2% in Era II (P = 0.000). Reduced hospital mortality improved the overall survival rates from Era I to Era II (78%, 74%, and 72% vs. 97.3%, 88.7%, and 85.1%, respectively) (P = 0.003). The 5-year survival rate of recipients with hepatocellular carcinoma (HCC) (n = 65) was 65.7%. Starting from Era II, excellent 5-year survival of recipients without HCC was achieved as compared with DDLT in the same period (93.4% vs. 88.2%) (P = 0.493). The 5-year survival rates of recipients with HCC within the Milan criteria of Era II and DDLT in the same period were 72.0% and 100%, respectively (P = 0.091). Multivariate analysis indicated that only Era I (relative risk = 2.606; P = 0.005) and pretransplant HCC (relative risk = 2.729; P = 0.002) adversely affected overall survival. Conclusions: High midterm survivals were achieved by reduction of hospital mortality through accumulation of experience and transplanting recipients with low chance of recurrence of HCC. RLDLT could be considered as a legitimate alternative to DDLT. © 2008 Lippincott Williams & Wilkins.en_HK
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.rightsAnnals of Surgery. Copyright © Lippincott Williams & Wilkins.en_HK
dc.titleA decade of right liver adult-to-adult living donor liver transplantation: The recipient mid-term outcomesen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0003-4932&volume=248&issue=3&spage=411&epage=419&date=2008&atitle=A+decade+of+right+liver+adult-to-adult+living+donor+liver+transplantation:+the+recipient+mid-term+outcomesen_HK
dc.identifier.emailChan, SC: chanlsc@hkucc.hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailWei, WI: hrmswwi@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityChan, SC=rp01568en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityWei, WI=rp00323en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/SLA.0b013e31818584e6en_HK
dc.identifier.pmid18791361-
dc.identifier.scopuseid_2-s2.0-52449094236en_HK
dc.identifier.hkuros151805en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-52449094236&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume248en_HK
dc.identifier.issue3en_HK
dc.identifier.spage411en_HK
dc.identifier.epage418en_HK
dc.identifier.isiWOS:000259475200012-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChan, SC=7404255575en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridLiu, CL=7409789712en_HK
dc.identifier.scopusauthoridWei, WI=7403321552en_HK
dc.identifier.scopusauthoridChik, BHY=15764573900en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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