Extension of the indication for living related liver transplantation from children to adults based on resolution of graft size mismatch in relation to tissue oxygenation and metabolic load: a case report

Transplant International : Official Journal of the European Society for Organ Transplantation
A TanakaY Yamaoka

Abstract

We extended the indication for living related partial liver transplantation from pediatric to adult cases. Our first case was a 49-year-old woman with primary biliary cirrhosis. Her sister's left lobe, weighing 280 g, was employed as a graft, and the graft weight/recipient's body weight ratio was calculated as 0.59%. To decrease the metabolic load to the relatively small graft, the total bilirubin was decreased from a maximum value of 75.0 mg/d1 to the most recent preoperative value of 36.2 mg/dl by plasma exchange. Intraoperative recovery of tissue oxygenation and its heterogeneity were satisfactory due to a relatively high blood supply. A postoperative decrease in bilirubin and increase in cholesterol esterification were facilitated, concomitant with regeneration of the graft, which weighed 280 g, to 860 cm3 at 3 weeks. Linear regression analysis with respect to tissue oxygenation and metabolic capacity obtained in pediatric cases were applied to this adult case.

References

Jul 1, 1991·Transplantation·Y YamaokaK Kumada
Oct 1, 1993·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·T KitaiK Hirao
Jan 1, 1996·Transplant International : Official Journal of the European Society for Organ Transplantation·A TanakaY Yamaoka

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Citations

Apr 9, 2008·Journal of Hepato-biliary-pancreatic Surgery·Satoru ImuraHirofumi Kanemura
Jun 18, 2011·Frontiers of Medicine·Nianqiao Gong, Xiaoping Chen
Nov 7, 2000·Current Surgery·T D JohnstonR M Mentzer
Nov 11, 1998·Journal of the American College of Surgeons·K UryuharaK Tanaka
Jul 2, 2005·European Journal of Clinical Pharmacology·Marie AntignacSaïk Urien
Dec 12, 2001·Transplantation·M KilicJ A Goss
Nov 8, 2001·Journal of Pediatric Gastroenterology and Nutrition·F Lacaille, E Sokal

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