Emiroglu R, Sevmis S, Moray G, Savas N, Haberal M
Department of General Surgery, Baskent University Faculty of Medicine, Ankara, Turkey.
Transplant Proc. 2007 May;39(4):1149-52. doi: 10.1016/j.transproceed.2007.02.052.
In the absence of cadaveric donor liver transplantation, living-donor liver transplantation (LDLT) is an alternative option for patients with end-stage liver disease. The objective of this study was to evaluate the outcome of LDLT at a single medical center in Turkey. We retrospectively analyzed the results of 101 LDLTs in 99 recipients with end-stage liver disease. We transplanted 49 right liver lobes, 16 left lobes, and 36 hepatic segments II and III. Most donors (46%) were parents of the recipients. Seventeen recipients had concomitant hepatocellular carcinoma and cirrhosis. Retransplantation was performed in two recipients. Ten hepatic arterial thromboses, 1 hepatic arterial bleeding, and 12 biliary leaks occurred in the early postoperative period. Most complications were treated with interventional techniques. Three hepatic vein stenoses, three portal vein stenoses, one hepatic arterial stenosis, and six biliary stenoses developed during the late postoperative period. Recipients with those complications were treated with interventional techniques. Mean follow-up was 14.2 +/- 10.9 months. During that time, no tumor recurrence was detected in any recipient with hepatocellular carcinoma. Twenty-two recipients died during the follow-up. At this time, the remaining 77 recipients (77%) are alive, exhibiting good graft function. In general, complication rates are slightly higher after LDLT than after cadaveric liver transplantation. However, most complications can be treated with interventional techniques. LDLT continues to be a life-saving option in countries without satisfactory cadaveric donation rates.
在缺乏尸体供肝移植的情况下,活体供肝移植(LDLT)是终末期肝病患者的一种替代选择。本研究的目的是评估土耳其一家医疗中心的活体供肝移植结果。我们回顾性分析了99例终末期肝病受者的101例活体供肝移植结果。我们移植了49个右肝叶、16个左肝叶以及36个肝段Ⅱ和Ⅲ。大多数供者(46%)是受者的父母。17例受者合并肝细胞癌和肝硬化。2例受者进行了再次移植。术后早期发生10例肝动脉血栓形成、1例肝动脉出血和12例胆漏。大多数并发症采用介入技术治疗。术后晚期发生3例肝静脉狭窄、3例门静脉狭窄、1例肝动脉狭窄和6例胆管狭窄。有这些并发症的受者采用介入技术治疗。平均随访时间为14.2±10.9个月。在此期间,任何肝细胞癌受者均未检测到肿瘤复发。22例受者在随访期间死亡。此时,其余77例受者(77%)存活,移植肝功能良好。总体而言,活体供肝移植后的并发症发生率略高于尸体肝移植。然而,大多数并发症可以采用介入技术治疗。在尸体捐献率不理想的国家,活体供肝移植仍然是一种挽救生命的选择。