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Treatment of inherited metabolic disorders by liver transplantation

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Journal of Inherited Metabolic Disease

Summary

Among the worldwide accepted indications for liver transplantation, inherited metabolic disorders play an increasing role. In some paediatric centres this indication runs second after extrahepatic biliary atresia.

The aim of liver transplantation in inherited metabolic disorders is twofold: the first is to save a patient's life, the second is to accomplish phenotypic and functional cure of his disease. These aims may be achieved in disorders presenting with cirrhosis, hepatoma, life-threatening progression or failure of other organs with preserved liver function. The timing of liver transplantation has become easier with development of surgical techniques of reduced-size donor livers. These techniques enable the performance of liver transplantation with ABO blood group compatible organs of almost any size if indicated either by deterioration of liver function or impending complications such as hepatoma or life-threatening progression. In comparison with other indications such as extrahepatic biliary atresia, postnecrotic liver cirrhosis or acute liver failure, the results of transplantation in patients with inherited metabolic disorders seem to be better, reaching up to 78–95% actuarial 1-year survival rates. However, lifelong immunosuppressive therapy is necessary. This seems to be acceptable even in disorders with only partial liver function defects.

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Authors and Affiliations

  1. Kinderklinik Medizinische Hochschule Hannover, Konstanty Gutschow Str. 8, D-3000, Hannover 61, Germany

    M. Burdelski, B. Rodeck, A. Latta, K. Latta & J. Brodehl

  2. Klinik für Abdominal- und Transplantations-Chirurgie, Konstanty Gutschow Str. 8, D-3000, Hannover 61, Germany

    B. Ringe & R. Pichlmayr

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  1. M. Burdelski
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  2. B. Rodeck
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  3. A. Latta
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Burdelski, M., Rodeck, B., Latta, A. et al. Treatment of inherited metabolic disorders by liver transplantation. J Inherit Metab Dis 14, 604–618 (1991). https://doi.org/10.1007/BF01797930

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