Elsevier

Transplantation Proceedings

Volume 41, Issue 7, September 2009, Pages 2868-2871
Transplantation Proceedings

Liver transplantation
Experience of Living Donor Liver Transplantation in Iran: A Single-Center Report

https://doi.org/10.1016/j.transproceed.2009.07.009Get rights and content

Abstract

Background

Living donor liver transplantation (LDLT) has been accepted as a valuable treatment for patients with end-stage liver disease seeking to overcome the shortage of organs and the waiting list mortality. The aim of this study was to report our experience with LDLT.

Methods

We retrospectively analyzed 50 LDLTs performed in our organ transplant center from January 1997 to March 2008. We reviewed the demographic data, family history, operative and hospital stay durations as well as postoperation complications among donors and recipients. We also performed a retrospective analysis of recipient chemical and biochemical data.

Results

Among 50 patients (30 males and 20 females) of overall mean age of 7.21 ± 5.35 who underwent LDLT (10 right lobe, 38 left lobe, and 2 left lateral segments), 47 received a liver graft from their parent, two from a brother, and one from an uncle. The most common indications for LDLT were end-stage liver disease due to Wilson's disease (16%), cryptogenic cirrhosis (16%), tyrosinemia (14%), biliary atresia (12%), autoimmune hepatitis (12%), and progressive familial intrahepatic cholestasis (12%). The mean follow-up was 16.91 ± 23.74 months. There were 13 (26%) recipient mortalities including vascular complications; three to sepsis after bowel perforation, two from liver dysfunction, two from chronic rejection due to noncompliance, and one from diffuse aspergillosis. The morbidity rate was 50%, including 19 reexplorations during the hospital course and five biliary complications.

Conclusion

This study demonstrated that LDLT can decrease the number of patients awaiting liver transplantation especially in the pediatric group. However, because of relatively high mortality and morbidity, we must improve our treatment outcomes.

Section snippets

Patients and Methods

Between January 1997 and March 2008, 50 patients with end-stage liver diseases received partial liver grafts from living donors. All surgical procedures were performed by same transplant surgeons. The demographics of the living donors and the recipients are listed in Table 1.

Results

Among 50 patients, 30 were males and 20 females. The mean age of the patients was 7.21 ± 5.34 years old at the time of operation. The most common indications for LDLT were end-stage liver disease due to Wilson's disease (16%); cryptogenic cirrhosis (16%); tyrosinemia (14%); biliary atresia (12%); autoimmune hepatitis (12%); and progressive familial intrahepatic cholestasis (12%). At the onset of the symptoms 18 patients were less than 2 years old; 13, between 2 and 5 years; and 19 more than 5

Discussion

In recent years, surgical techniques have improved and new immunosuppressive agents have been introduced, but the number of potential donor organs is far out of proportion to the increasing demand for liver transplantation. Deceased donor liver transplantation has rescued many patients with end-stage liver diseases, but its availability is limited. LDLT may be a useful alternative to overcome the organ shortage and reduce list mortality. The donor hepatectomy, especially a right lobe

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