Department of Surgery, Division of Transplantation, Shinshu University School of Medicine, Matsumoto, Japan.
Am J Transplant. 2012 Aug;12(8):2211-9. doi: 10.1111/j.1600-6143.2012.04061.x. Epub 2012 Apr 14.
Donor shortage is a major issue in liver transplantation. We have successfully performed temporary auxiliary partial orthotopic liver transplantation (APOLT) using a small volume graft procured from a living donor for recipients with familial amyloid polyneuropathy (FAP). The aim of this study was to evaluate this procedure by comparing it with standard living donor liver transplantation (LDLT). We compared 13 recipients undergoing this procedure with 23 recipients undergoing a standard LDLT for the treatment of FAP. The estimated donor graft volume and the graft volume/recipient's standard liver volume ratio were significantly smaller in the temporary APOLT group than in the standard LDLT group. Postoperative complications were comparable, although the hospital stay was longer in the temporary APOLT group. All the patients safely underwent a remnant native liver resection about 2 months after their first operation in the temporary APOLT group. No symptoms related to FAP developed before the remnant liver resection, and no significant differences in graft and patient survival were observed between the two groups. We successfully performed temporary APOLT using a small volume liver graft without postoperative liver failure for FAP. Temporary APOLT for FAP might be a useful alternative procedure for expanding the donor pool for LDLT.
供体短缺是肝移植的一个主要问题。我们已经成功地使用来自活体供体的小体积移植物进行了临时辅助部分原位肝移植（APOLT），用于治疗家族性淀粉样多神经病（FAP）的患者。本研究旨在通过与标准活体供肝移植（LDLT）进行比较来评估该手术。我们比较了 13 名接受此手术的患者与 23 名接受标准 LDLT 治疗 FAP 的患者。临时 APOLT 组的估计供体移植物体积和移植物体积/受体标准肝体积比明显小于标准 LDLT 组。尽管临时 APOLT 组的住院时间更长，但术后并发症相当。在临时 APOLT 组中，所有患者在第一次手术约 2 个月后均安全地进行了剩余的原生肝切除术。在剩余肝切除术前，没有与 FAP 相关的症状，并且两组之间在移植物和患者存活率方面没有观察到显著差异。我们成功地使用小体积肝移植物进行了临时 APOLT，没有发生术后肝功能衰竭，用于 FAP。对于 LDLT，临时 APOLT 可能是扩大供体库的一种有用替代方法。
