Abstract
In view of the relative scarcity of pediatric cadaveric donors, living-related liver transplantation has recently been accepted as an alternative approach. It is also the only method of liver transplantation available in countries where cadaveric organ procurement is prohibited. Here we describe our experience of living-related liver transplantation in 17 patients at Shinshu University Hospital. The safety of the donor operation is of paramount importance in this type of liver transplantation. In Japan, retransplantation is very difficult in the event of the liver graft becoming nonfunctional. We have therefore placed emphasis on the donor hepatectomy technique as well as on surgical procedures and postoperative care to prevent graft loss in the recipient. Fifteen of the 17 patients who received liver transplants are currently alive; and 1 died of cytomegalovirus infection, and 1 of pulmonary complications. The actuarial 1-year survival rate for our series, determined by Kaplan-Meier analysis, was 89.5%. Although living-related liver transplantation requires a complicated surgical procedure, it has achieved reasonable results for both donors and recipients. We consider that living-related liver transplantation is a useful and reasonable option for patients requiring liver transplantation.
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Emond JC, Whitington PF, Thistlewaite JR, Alonso EM, Broelsch CE (1989) Reduced-size orthotopic liver transplantation: Use in the management of children with chronic liver disease. Hepatology 10:867–872
Bismuth H, Houssin D (1984) Reduced-size orthotopic liver graft in hepatic transplantation in children. Surgery 95:367–378
Pichlmayr R, Ringe B, Gubernatis G, Hauss J, Bunzendahl H (1988) Transplantation of one donor liver to two recipients (splitting transplantation): A new method for further development of segmental liver transplantation. Langenbecks Arch Chir 373:127–130
Broelsch CE, Stevens LH, Whitington PF (1991) The use of reduced-size liver transplantation in children, including split livers and living-related liver transplants. Eur J Pediatr Surg 1:166–171
Makuuchi M, Kawarazaki H, Iwanaka T, Kamada N, Takavama T, Kumon M (1992) Living-related liver transplantation. Surg Today 22:297–300
Kawasaki S, Makuuchi M, Matsunami H, Hashikura Y, Ikegami T, Chisuwa H, Ikeno T, Noike T, Takayama T, Kawarazaki H (1993) Preoperative measurement of segmental liver volume of donors for living-related liver transplantation. Hepatology 18:1115–1120
Makuuchi M, Kawasaki S, Noguchi T, Hashikura Y, Matsunami H, Hayashi K, Harada H, Kakazu T, Takayama T, Kawarasaki H (1993) Donor hepatectomy for living-related partial liver transplantation. Surgery 113:395–402
Strong RW, Lynch SV, Ong TH, Matsunami H, Koido Y, Balderson GA (1990) Successful liver transplantation from a living donor to her son. N Engl J Med 322:1505–1507
Nakadaira K, Tsukada K, Sakaguchi T, Shirai Y, Kurosaki I, Ohtake M, Yoshida K, Muto T (1993) A pharmacological analysis of effects of prostaglandin E1 on portal blood flow after partial hepatectomy in rats. Surg Today 23:277–279
Kitahara S, Makuuchi M, Kawasaki S, Ishizone S, Matsunami H, Kamada N, Kawarazaki H, Iwanaka T (1991) Lymphoproliferative disorders after FK 506. Lancet 337:1234
Matsunami H, Makuuchi M, Kawasaki S, Ishizone S, Mizusawa Y, Kawarasaki H, Takayama T (1992) Living-related liver transplantation in fulminant hepatic failure. Lancet 340: 1411–1412
Hashikura Y, Makuuchi M, Kawasaki S, Matsunami H, Ikegami T, Nakazawa Y, Kiyosawa K, Ichida T (1994) Successful living-related partial liver transplantation to an adult patient. Lancet 343:1233–1234
Makuuchi M, Mori T, Gunvén P, Yamazaki S, Hasegawa H (1987) Safety of hemihepatic vascular occlusion during resection of the liver. Surg Gynecol Obstet 164:155–158
Matsunami H, Makuuchi M, Kawasaki S, Ishizone S, Hashikura Y, Ikegami T, Kawarasaki H, Iwanaka T, Takayama T, Khono S (1993) Living-related liver transplantation despite major arterial and venous abnormalities. Transplantation 56:753–755
Van Thiel DH, Carr B, Iwatsuki S, Selby RR, Fung JJ, Starzl TE (1993) The 11-year Pittsburgh experience with liver transplantation: 1981–1991. J Surg Oncol [Suppl] 3:78–82
D'Alessandro AM, Ploeg RJ, Knechtle SJ, Pirsch JD, Stegall MD, Hoffmann R, Sollinger HW, Belzer FO, Kalayoglu M (1993) Retransplantation of the liver — a 7-year experiene. Transplantation 55:1083–1087
Kasai H, Makuuchi M, Kawasaki S, Ishizone S, Kitahara S, Matsunami H (1992) Intraoperative color Doppler ultrasonography for partial-liver transplantation. Transplantation 54:173–175
Kawasaki S, Makuuchi M, Ishizone S, Matsunami H, Terada M, Kawarazaki H (1992) Liver regeneration in recipients and donors after transplantation. Lancet 339:580–581
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This work was supported in part by a grant-in-aid for scientific research from the Ministry of Education, Science and Culture of Japan (03404037, 04557056).
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Hashikura, Y., Makuuchi, M., Kawasaki, S. et al. Living-related liver transplantation: Report of experiences at Shinshu University Hospital. J Hep Bil Pancr Surg 2, 52–57 (1995). https://doi.org/10.1007/BF02348288
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DOI: https://doi.org/10.1007/BF02348288