Successful living-related partial liver transplantation to an adult patient

Hashikura, Yasuhiko; Makuuchi, Masatoshi; Kawasaki, Seiji; Matsunami, Hidetoshi; Ikegami, Toshihiko; Nakazawa, Yūichi; Kiyosawa, Kendo; Ichida, Takafumi

doi:10.1016/s0140-6736(94)92450-3

Cited by 364 publications

(181 citation statements)

References 2 publications

Supporting

Mentioning

175

Contrasting

Unclassified

Order By: Relevance

“…This was followed by the report of Strong et al 2 in Australia, where the first successful transplantation in a child using its mother's left lobe was performed in July 1989. The first successful LRLT for an adult patient was reported by Hashikura et al 3 at Shinshu University. Recently, the number of LRLTs has increased.…”

mentioning

confidence: 99%

Safe donor hepatectomy for living related liver transplantation

Sugawara

Makuuchi

Takayama

et al. 2002

Liver Transplantation

View full text Add to dashboard Cite

Minimizing the risk of donor hepatectomy while preserving graft viability is an important concern in living related liver transplantation. This report describes clinical outcomes for living donor hepatectomy with reference to the type of hepatectomy. Donor hepatectomy was performed in 130 consecutive living donors. They were divided into three groups: left lateral or extended left lateral segmentectomy (group S; n ‫؍‬ 50), left hepatectomy with or without caudate lobe or right lateral resection (group L; n ‫؍‬ 64), and right hepatectomy (group R; n ‫؍‬ 16). Intraoperative and postoperative data were examined and compared among the groups. No critical complications were observed in any group. However, there were differences in donor age, surgical and ischemia times, volume of blood loss, graft weight, and aspartate aminotransferase level elevation among the groups. Livers showed a substantial increase in volume, tending to the standard liver volume 1 month after surgery. Regardless of the extent of donor hepatectomy, serious complications did not occur after surgery. Surgical risk for a living donor is minimal if the operation is performed by experienced surgeons using present procedures. (Liver Transpl 2002;8:58-62.)

show abstract

mentioning

confidence: 99%

Safe donor hepatectomy for living related liver transplantation

Sugawara

Makuuchi

Takayama

et al. 2002

Liver Transplantation

View full text Add to dashboard Cite

show abstract

“…We described the first successful LRLT in a patient with FHF in 1992 9 and the first successful LRLT in an adult patient in 1994. 10 Here, we report our experience with LRLT in 8 patients with FHF (including 2 adult patients) and 6 patients with SFHF (including 2 adult patients). Thirteen of the 14 are still alive.…”

mentioning

confidence: 99%

Living-related liver transplantation for patients with fulminant and subfulminant hepatic failure

et al. 1999

Self Cite

View full text Add to dashboard Cite

The prognosis for patients with fulminant (FHF) or subfulminant hepatic failure (SFHF) has improved since the introduction of liver transplantation. However, the death rate of patients awaiting liver transplantation is high, possibly because of the difficulty in obtaining grafts in a timely manner, given the relative shortage of cadaveric donors. Between June 1990 and June 1999, 106 patients underwent living-related liver transplantation (LRLT) at Shinshu University Hospital. Among them, 8 patients had FHF and 6 had SFHF; these 14 patients are the subjects of this report. The graft volumes (GV) ranged from 231 mL to 625 mL, corresponding to 35% to 105% of the recipients' standard liver volume (SLV). The postoperative courses of all donors were uneventful. Following liver transplantation, all grafts functioned favorably, with normalization of serum total bilirubin within 3 to 5 days and normalization of coagulation profiles within 4 to 7 days. Thirteen of the 14 recipients are still alive. The actuarial 6-month, 1-year, and 5-year survival rates were 100%, 90%, and 90%, respectively. In the present study, when the ratio of the GV to the recipient's SLV was more than 35%, the graft was able to support the patient's metabolic demand after liver transplantation for FHF or SFHF. Because of the urgent nature of liver transplantation in this clinical condition, concerns over informed consent may be even greater than for elective LRLT. Nevertheless, the high success rate and low donor risk may justify this option for pediatric patients, as well as for a limited population of adult patients suffering from FHF or SFHF. (HEPATOLOGY 1999;30:1521-1526.)The prognosis for patients with fulminant hepatic failure (FHF) and subfulminant hepatic failure (SFHF) has improved since the introduction of orthotopic liver transplantation. 1 The survival rate of patients with these conditions who undergo liver transplantation is in the range of 56% to 80%, 2-4 compared with the 15% to 20% survival rate of patients who do not undergo transplantation, even with improved medical treatment. 5 Because FHF is rapidly progressive and irreversible, the need for liver transplantation is urgent. The death rate of patients awaiting liver transplantation is as high as 40% 6 or 62%, 7 possibly as a result of the difficulty of obtaining grafts in a timely manner, given the relative shortage of cadaveric donors.Living-related liver transplantation (LRLT) has been developed as an alternative to cadaveric liver transplantation. To avoid ethical dilemmas in LRLT, including any potential coercion of the live donor candidates, we have pursued a strict policy of ensuring that the participants in LRLT are fully informed of all aspects and risks of the procedure before we obtain their consent. As favorable results for LRLT have accumulated, reluctance toward the procedure has gradually subsided. Given this success, it is worth considering LRLT for patients with FHF, provided that each situation is considered with special care because of the short amount of time...

show abstract

“…Although the frequency of bile leakage and biliary stenosis were similar between the recipients of RLGs and RLSGs, we found that more than two biliary anastomoses was a significant risk n.a., not available. 1 Minor complications (1-2) and major complications (3)(4) were classified according to the classification of Dindo et al (18). 2 Precise complication grade according to the classification of Dindo et al (18) was not available.…”

Section: Discussionmentioning

confidence: 99%

“…Left liver grafts (LLGs) were initially used in adult LDLT in the 1990s in consideration of the donors' safety (3). Subsequently, to meet the metabolic demand of adult recipients, right liver graft (RLG) procurement started to be performed (4).…”

Section: Introductionmentioning

confidence: 99%

Use of a Right Lateral Sector Graft in Living Donor Liver Transplantation Is Feasible, but Special Caution Is Needed With Respect to Liver Anatomy

Kobayashi

Hasegawa

Arita

et al. 2016

American Journal of Transplantation

View full text Add to dashboard Cite

Right lateral sector (RLS) grafting has been introduced to enlarge the potential donor pool for living donor liver transplantation (LDLT); however, evidence of its feasibility is limited. Data from 437 LDLTs carried out between 2000 and 2013 were analyzed retrospectively. LDLTs using a right liver graft (n = 251) were compared with those using a RLS graft (RLSG; n = 28). No donor mortality occurred, and the major complication rates were similar between the two groups. Postoperative liver function preservation was better in the RLSG donors. Concerning the recipients, the mortality and overall survival rates were similar between the two groups. The complication rate for the recipients was higher when more than two arterial or biliary anastomoses were necessary. A systematic literature search identified four reports on LDLT using RLSGs. Among 66 LDLTs, including the present series, there were no cases of donor death, and the rates of major and minor complications in the donors were 6% and 29%, respectively. The major complication and overall mortality rates in the recipients were 29% and 6%, respectively. LDLT using an RLSG is feasible, with an acceptable survival rate among the recipients.Abbreviations: A6, A7, and A8, hepatic arteries flowing into segments 6, 7, and 8, respectively; ALT, serum alanine aminotransferase; AST, serum aspartate aminotransferase; HAT, hepatic artery thrombosis; INR, international normalized ratio; IQR, interquartile range; LDLT, living donor liver transplantation; LLG, left liver graft; MELD, model for endstage liver disease; n.a., not available; RAHA, right anterior hepatic artery; RHA, right hepatic artery; RLG, right liver graft; RL, right liver; RLSG, right lateral sector graft; RLS, right lateral sector; RPHA, right posterior hepatic artery; RPPV, right posterior portal vein; SLV, standard liver volume

show abstract

Successful living-related partial liver transplantation to an adult patient

Cited by 364 publications

References 2 publications

Safe donor hepatectomy for living related liver transplantation

Safe donor hepatectomy for living related liver transplantation

Living-related liver transplantation for patients with fulminant and subfulminant hepatic failure

Use of a Right Lateral Sector Graft in Living Donor Liver Transplantation Is Feasible, but Special Caution Is Needed With Respect to Liver Anatomy

Contact Info

Product

Resources

About