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
2011 Impact Factor: 4.003
2011 SCImago Journal Rankings: 0.380
DOIhttp://dx.doi.org/10.1097/00007890-199901150-00012
ISI Accession Number IDWOS:000078118300012
ReferencesReferences in Scopus
DC Field
Value
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
2011 Impact Factor: 4.003
2011 SCImago Journal Rankings: 0.380
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
Author Affiliations
  1. The University of Hong Kong