Soejima Y, Taketomi A, Yoshizumi T, Uchiyama H, Harada N, Ijichi H, Yonemura Y, Shimada M, Maehara Y
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Am J Transplant. 2006 May;6(5 Pt 1):1004-11. doi: 10.1111/j.1600-6143.2006.01284.x.
Operative mortality for a right lobe (RL) donor in adult living donor liver transplantation (LDLT) is estimated to be as high as 0.5-1%. To minimize the risk to the donor, left lobe (LL)-LDLT might be an ideal option in adult LDLT. The aim of the study was to assess the feasibility of LL-LDLT between adults based on a single-center experience of 107 LL-LDLTs performed over 8 years. The mean graft weight of LL grafts was 452 g, which amounted to 40.5% of the estimated standard liver volume of the recipients. The overall 1-, 3- and 5-year patient survival rates in LL-LDLT were 81.4, 76.9 and 74.7%, respectively, which were comparable to those of RL-LDLT. Twenty-six grafts (24.3%) were lost for various reasons with three losses directly attributable to small-for-size graft syndrome. Post-operative liver function and hospital stay in LL donors were significantly better and shorter than that in RL donors, while the incidence of donor morbidity was comparable between LL and RL donors. In conclusion, LL-LDLT was found to be a feasible option in adult-to-adult LDLT. Further utilization of LL grafts should be undertaken to keep the chance of donor morbidity and mortality minimal.
在成人活体肝移植（LDLT）中，右叶（RL）供体的手术死亡率估计高达0.5 - 1%。为了将供体风险降至最低，左叶（LL）-LDLT可能是成人LDLT的理想选择。本研究的目的是基于一个中心在8年期间进行的107例LL-LDLT的单中心经验，评估成人之间LL-LDLT的可行性。LL移植物的平均重量为452克，占受者估计标准肝脏体积的40.5%。LL-LDLT中患者的1年、3年和5年总生存率分别为81.4%、76.9%和74.7%，与RL-LDLT的生存率相当。26例移植物（24.3%）因各种原因丢失，其中3例直接归因于小体积移植物综合征。LL供体的术后肝功能和住院时间明显优于RL供体且更短，而LL和RL供体的供体并发症发生率相当。总之，LL-LDLT被发现是成人对成人LDLT的一种可行选择。应进一步利用LL移植物，以使供体并发症和死亡率的几率降至最低。
