Sevmis S, Moray G, Savas N, Torgay A, Bilezikci B, Haberal M
Department of General Surgery, Baskent University Faculty of Medicine, Ankara, Turkey.
Transplant Proc. 2007 May;39(4):1145-8. doi: 10.1016/j.transproceed.2007.02.050.
Living-donor liver transplantation is another treatment option to cadaveric liver transplantation in adult recipients. We report the outcomes of 49 right lobe adult living-donor liver transplantations performed at our institution between April 2003 and June 2006. The mean age of the recipients was 41.7 +/- 12.5 years. The median graft-to-recipient weight ratio was 1.2% +/- 0.4%. In recipients, the mean operative time was 10.6 +/- 2.7 hours. The mean number of blood transfusions administered was 4.1 +/- 5.1 units. The mean time spent in the intensive care unit was 2.3 +/- 1.5 days. In recipients, five vascular and five biliary complications occurred during the early postoperative period, and four vascular and two biliary complications developed in the late postoperative period. Thirteen of the 49 recipients died within 4 months of surgery. The mean age of the donors was 36.6 +/- 9 years. In the donors, the mean operative time was 6.4 +/- 1.6 hours, mean residual liver volume was 43.3% +/- 6.1%, and the mean hospital stay was 9.5 +/- 4.5 days. Two donors required an intraoperative blood transfusion. None of our donors died, but six complications occurred in four donors. The mean postoperative follow-up was 13.4 +/- 9.6 months. In conclusion, in Turkey, as in other countries, organ demand exceeds organ availability. Graft size presents a problem for adult recipients, but right lobe living donor transplant may be a life-saving option for these recipients when performed by experienced surgical teams.
活体供肝肝移植是成年受者尸体肝移植之外的另一种治疗选择。我们报告了2003年4月至2006年6月在我们机构进行的49例右叶成年活体供肝肝移植的结果。受者的平均年龄为41.7±12.5岁。移植物与受者体重比的中位数为1.2%±0.4%。在受者中，平均手术时间为10.6±2.7小时。平均输血单位数为4.1±5.1单位。在重症监护病房的平均停留时间为2.3±1.5天。在受者中，术后早期发生了5例血管并发症和5例胆道并发症，术后晚期出现了4例血管并发症和2例胆道并发症。49例受者中有13例在术后4个月内死亡。供者的平均年龄为36.6±9岁。在供者中，平均手术时间为6.4±1.6小时，平均残余肝体积为43.3%±6.1%，平均住院时间为9.5±4.5天。2例供者术中需要输血。我们的供者均未死亡，但4例供者出现了6例并发症。术后平均随访时间为13.4±9.6个月。总之，在土耳其，与其他国家一样，器官需求超过了器官供应。移植物大小对成年受者来说是个问题，但由经验丰富的手术团队进行右叶活体供肝移植可能是这些受者的一种挽救生命的选择。
