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Article: Applicability of living donor liver transplantation to high-urgency patients
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TitleApplicability of living donor liver transplantation to high-urgency patients
 
AuthorsLo, CM1
Fan, ST1
Liu, CL1
Wei, WI1
Chan, JK1
Lai, CL1
Lau, GK1
Wong, J1
 
Issue Date1999
 
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.transplantjournal.com
 
CitationTransplantation, 1999, v. 67 n. 1, p. 73-77 [How to Cite?]
DOI: http://dx.doi.org/10.1097/00007890-199901150-00012
 
AbstractBackground. Cadaveric liver donors are scarce in Hong Kong, and the application of liver transplantation to high-urgency patients is limited. We evaluated the use of grafts from living donors in this setting. Methods. From July 1994 to January 1998, 49 consecutive adult patients who were intensive care unit-bound because of acute or chronic liver failure were put on a high- urgency list for liver transplantation. Family members were not solicited for living donation, and the initiation and decision for living donor liver transplantation (LDLT) was based on the donor's voluntary intent. Assessment of the living donor, including blood tests, computed tomographic volumetry, and angiography, was performed only after informed consent was executed. Results. In 25 of 49 (51%) patients, no family member volunteered as living donor; 23 died awaiting donor organs, and 2 received a cadaveric graft. Twenty-four (49%) patients had 36 family members who volunteered as living donors. Before evaluation of living donor was completed, two patients received a cadaveric liver transplant. LDLT was not performed in nine patients because of recipient contraindications (n=4), ABO blood group incompatibility (n=3), and withdrawal of donor (n=2). Eight of these nine patients died, and one received a cadaveric liver graft. The remaining 13 (27%) patients received grafts from living donors. Four of 5 (80%) patients who underwent cadaveric liver transplantation and 11 of 13 (85%) who underwent LDLT survived. Thus, emergency transplantation from living donors increased the applicability of liver transplantation from 10% to 37%, and the survival rate after emergency LDLT (85%) was superior to that of the remaining patients (11%). Conclusions. When cadaveric organ donation is scarce, emergency liver transplantation from living donors can be applied to high-urgency adult patients.
 
ISSN0041-1337
2013 Impact Factor: 3.535
2013 SCImago Journal Rankings: 1.609
 
DOIhttp://dx.doi.org/10.1097/00007890-199901150-00012
 
ISI Accession Number IDWOS:000078118300012
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorLo, CM
 
dc.contributor.authorFan, ST
 
dc.contributor.authorLiu, CL
 
dc.contributor.authorWei, WI
 
dc.contributor.authorChan, JK
 
dc.contributor.authorLai, CL
 
dc.contributor.authorLau, GK
 
dc.contributor.authorWong, J
 
dc.date.accessioned2010-09-06T07:19:50Z
 
dc.date.available2010-09-06T07:19:50Z
 
dc.date.issued1999
 
dc.description.abstractBackground. Cadaveric liver donors are scarce in Hong Kong, and the application of liver transplantation to high-urgency patients is limited. We evaluated the use of grafts from living donors in this setting. Methods. From July 1994 to January 1998, 49 consecutive adult patients who were intensive care unit-bound because of acute or chronic liver failure were put on a high- urgency list for liver transplantation. Family members were not solicited for living donation, and the initiation and decision for living donor liver transplantation (LDLT) was based on the donor's voluntary intent. Assessment of the living donor, including blood tests, computed tomographic volumetry, and angiography, was performed only after informed consent was executed. Results. In 25 of 49 (51%) patients, no family member volunteered as living donor; 23 died awaiting donor organs, and 2 received a cadaveric graft. Twenty-four (49%) patients had 36 family members who volunteered as living donors. Before evaluation of living donor was completed, two patients received a cadaveric liver transplant. LDLT was not performed in nine patients because of recipient contraindications (n=4), ABO blood group incompatibility (n=3), and withdrawal of donor (n=2). Eight of these nine patients died, and one received a cadaveric liver graft. The remaining 13 (27%) patients received grafts from living donors. Four of 5 (80%) patients who underwent cadaveric liver transplantation and 11 of 13 (85%) who underwent LDLT survived. Thus, emergency transplantation from living donors increased the applicability of liver transplantation from 10% to 37%, and the survival rate after emergency LDLT (85%) was superior to that of the remaining patients (11%). Conclusions. When cadaveric organ donation is scarce, emergency liver transplantation from living donors can be applied to high-urgency adult patients.
 
dc.description.naturelink_to_subscribed_fulltext
 
dc.identifier.citationTransplantation, 1999, v. 67 n. 1, p. 73-77 [How to Cite?]
DOI: http://dx.doi.org/10.1097/00007890-199901150-00012
 
dc.identifier.doihttp://dx.doi.org/10.1097/00007890-199901150-00012
 
dc.identifier.epage77
 
dc.identifier.hkuros39518
 
dc.identifier.isiWOS:000078118300012
 
dc.identifier.issn0041-1337
2013 Impact Factor: 3.535
2013 SCImago Journal Rankings: 1.609
 
dc.identifier.issue1
 
dc.identifier.openurl
 
dc.identifier.pmid9921799
 
dc.identifier.scopuseid_2-s2.0-0033556468
 
dc.identifier.spage73
 
dc.identifier.urihttp://hdl.handle.net/10722/76306
 
dc.identifier.volume67
 
dc.languageeng
 
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.transplantjournal.com
 
dc.publisher.placeUnited States
 
dc.relation.ispartofTransplantation
 
dc.relation.referencesReferences in Scopus
 
dc.rightsTransplantation. Copyright © Lippincott Williams & Wilkins.
 
dc.subject.meshAdolescent
 
dc.subject.meshAdult
 
dc.subject.meshAged
 
dc.subject.meshCadaver
 
dc.subject.meshEmergency Medical Services
 
dc.subject.meshFemale
 
dc.subject.meshHumans
 
dc.subject.meshLiver Failure - surgery
 
dc.subject.meshLiver Transplantation
 
dc.subject.meshLiving Donors
 
dc.subject.meshMale
 
dc.subject.meshMiddle Aged
 
dc.subject.meshTreatment Outcome
 
dc.subject.meshWaiting Lists
 
dc.titleApplicability of living donor liver transplantation to high-urgency patients
 
dc.typeArticle
 
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<contributor.author>Liu, CL</contributor.author>
<contributor.author>Wei, WI</contributor.author>
<contributor.author>Chan, JK</contributor.author>
<contributor.author>Lai, CL</contributor.author>
<contributor.author>Lau, GK</contributor.author>
<contributor.author>Wong, J</contributor.author>
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<description.abstract>Background. Cadaveric liver donors are scarce in Hong Kong, and the application of liver transplantation to high-urgency patients is limited. We evaluated the use of grafts from living donors in this setting. Methods. From July 1994 to January 1998, 49 consecutive adult patients who were intensive care unit-bound because of acute or chronic liver failure were put on a high- urgency list for liver transplantation. Family members were not solicited for living donation, and the initiation and decision for living donor liver transplantation (LDLT) was based on the donor&apos;s voluntary intent. Assessment of the living donor, including blood tests, computed tomographic volumetry, and angiography, was performed only after informed consent was executed. Results. In 25 of 49 (51%) patients, no family member volunteered as living donor; 23 died awaiting donor organs, and 2 received a cadaveric graft. Twenty-four (49%) patients had 36 family members who volunteered as living donors. Before evaluation of living donor was completed, two patients received a cadaveric liver transplant. LDLT was not performed in nine patients because of recipient contraindications (n=4), ABO blood group incompatibility (n=3), and withdrawal of donor (n=2). Eight of these nine patients died, and one received a cadaveric liver graft. The remaining 13 (27%) patients received grafts from living donors. Four of 5 (80%) patients who underwent cadaveric liver transplantation and 11 of 13 (85%) who underwent LDLT survived. Thus, emergency transplantation from living donors increased the applicability of liver transplantation from 10% to 37%, and the survival rate after emergency LDLT (85%) was superior to that of the remaining patients (11%). Conclusions. When cadaveric organ donation is scarce, emergency liver transplantation from living donors can be applied to high-urgency adult patients.</description.abstract>
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<subject.mesh>Liver Failure - surgery</subject.mesh>
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Author Affiliations
  1. The University of Hong Kong