Dual liver transplantation

Abstract

Reperfusion is the key strategy in acute ST-segment elevation myocardial infarction (STEMI) care, and it is time-dependent. Shortening the time from symptom to reperfusion and choosing the optimal reperfusion strategy for STEMI patients are great challenges in practice. We need to improve upon the problems of low reperfusion rate, non-standardized treatment, and economic burden in STEMI care. This article briefly reviews the current status of reperfusion strategy in STEMI care, and also introduces what we will do to bridge the gap between the guidelines and implementation in the clinical setting through the upcoming China STEMI early reperfusion program.

The first two cases of living donor liver transplantation using dual grafts in Saudi Arabia

“…This may manifest in the form of inadequate remnant liver volume, which in a few extreme cases has led to liver failure, resulting in death or the need for liver transplantation in the liver donor 7,14. The balance between the recipient graft volume requirement to avoid small-for-size syndrome (SFSS) and the donor’s safety is considered to be a crucial factor in the era of LDLT 10…”

“…Dual-graft living donor liver transplantation maximizes donor safety by minimizing the resection volume from each donor, which correlates with post-hepatectomy mortality rates; the worldwide donor mortality estimate for left lateral segmentectomy is 0.1% while for right lobe donors it is 0.4%–0.5% 8,9. Currently, five types of dual-graft pairs have been used to carry out dual-graft living donor liver transplantation: 1) two left lobes grafts, 2) two left lateral segments, 3) one right lobe graft and one left lobe graft, 4) one right lobe graft and one left lateral segment, and lastly 5) one left lobe graft and one left lateral segment 5,6,10. We report the first two cases of dual-graft adult-to-adult LDLT in Saudi Arabia performed at the King Faisal Specialist Hospital and Research Centre using one left lobe graft and one left lateral segment graft in both cases.…”

Preliminary study of donor volume changes after dual-graft liver transplantation in rats

“…To curb this problem, right lobe implantation is always the most appropriate and best for surgical purposes ( 4 ). However, donor safety in liver transplantation is often the most important precaution and consideration ( 14 ). Although right lobe donation can meet the needs of recipients, the remaining left lobe sometimes endangers the donor due to small size and insufficient residual liver function ( 13 ).…”

“…Compared to traditional liver transplantation, the striking feature is that it requires two donors, which makes the donor safer because it theoretically reduces the donor’s donated liver volume. Henceforth, it meets the receptor’s physiological functions of the liver and reduces the donor’s risk to hazardous conditions simultaneously ( 14 ). The main reason is that the graft provided by two donors could provide the recipient with a relatively sufficient liver, improve the survival rate of the recipient, and reduce complications ( 19 ).…”

Development of an improved rat model of dual graft liver transplantation with long-term survival

“…In our transplant center, we performed the first DLT in a patient with acute-on-chronic hepatitis B liver failure in 2010 (Zheng SS, Wu J, Xu X, Sheng Y, et al, unpublished result). Nowadays, DLT has been demonstrated to be feasible as well as effective in increasing the donor pool and in preventing the potential for SFSS (Chen et al, 2013). However, little is known about the pathophysiological and immune processes following DLT due to the lack of appropriate animal models.…”