PMID: 11905081Mar 22, 2002Paper

Preliminary results of adult-to-adult living donor liver transplantation: improved size matching and better outcomes with right lobe versus left lobe grafts

Harefuah
Moshe Ben-Haim

Abstract

Grafts from living donors are a novel alternative to cadaveric organs for adult liver recipients. Twenty adults (mean age, 46 +/- 15 years; mean weight, 68 +/- 12 kg) received left lobes (n = 10; mean weight, 481 +/- 73 g) or right lobes (n = 10; mean weight, 805 +/- 115 g) from living donors (mean age, 38 +/- 10 years; mean weight, 85 +/- 9 kg). Hepatectomy was done using ultrasonic scissors, without vascular isolation. Transplantation was performed in a piggy-back fashion. Biliary reconstruction was performed with a single hepatico-enterostomy to the left duct for LL grafts and with 2 (n = 8) or 3 (n = 2) hepatico-enterostomies in RL grafts. All donors recovered without significant complications or heterologous transfusion. Three recipients (15%) died. Graft survival is 70% (mean follow-up, 8 months). Mean graft: recipient weight ratios (GRWR) were 0.75% +/- 0.21% (range, 0.51-1.06) in LL recipients, and 1.10% +/- 0.15% (range, 0.93-1.44) in RL recipients. Four recipients of relatively small LL grafts (GRWR < 0.8%), all with Child's B or C cirrhosis, developed small-for-size syndrome. One died; 2 required retransplantation. Small LL grafts were used successfully in Child's A patients or non-cirrhotics (the indication for tran...Continue Reading

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