Inomata Y, Zeledón M E, Asonuma K, Okajima H, Takeichi T, Ishiko T, Ando Y
Department of Pediatric Surgery and Transplantation, Faculty of Medical and Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan.
Am J Transplant. 2007 Jun;7(6):1629-32. doi: 10.1111/j.1600-6143.2007.01828.x.
Grafts used in Domino liver transplantation (LT) obtained from living donor liver transplantation (LDLT) for familial amyloid polyneuropathy (FAP) patients have been mainly used as reduced grafts. Because of small-for-size problems seen in LDLT, using whole liver grafts could improve post-LT outcome. Eight consecutive Domino LDLT using whole livers without retrohepatic inferior vena cava (IVC) from FAP patients were retrospectively analyzed. The graft weight/recipient's body weight ratio (GWRW) in the domino recipients ranged from 1.28% to 2.4% (mean: 1.52). Multiple vascular reconstructions in the whole-liver domino LT resulted in longer than usual warm ischemia time (mean: 64 min); however immediate post-operative recovery of hepatic function was uneventful. At 8-40 months after the transplant, all the FAP patients are well and all of the domino recipients are alive. Domino LT using a whole FAP liver from a LDLT for a FAP patient presents satisfactory results, even though the transplant procedure is technically complicated.
用于家族性淀粉样多神经病（FAP）患者活体肝移植（LDLT）的多米诺肝移植（LT）移植物主要用作减体积移植物。由于LDLT中存在小肝综合征问题，使用全肝移植物可能会改善肝移植术后的结局。对8例连续使用FAP患者的无肝后下腔静脉（IVC）全肝进行的多米诺LDLT进行回顾性分析。多米诺受体的移植物重量/受体体重比（GWRW）范围为1.28%至2.4%（平均：1.52）。全肝多米诺LT中的多次血管重建导致热缺血时间比通常更长（平均：64分钟）；然而，术后肝功能立即恢复顺利。移植后8至40个月，所有FAP患者情况良好，所有多米诺受体均存活。尽管移植手术在技术上很复杂，但使用来自FAP患者LDLT的全FAP肝进行多米诺LT仍呈现出令人满意的结果。
