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Adult-to-adult living-donor liver transplantation: The experience of the Université catholique de Louvain

Hepatobiliary & Pancreatic Diseases International 2019年第2期18卷 132-142页

作者： Samuele Iesari Milton Eduardo Inostroza Nú?ez Juan Manuel Rico Juri Olga Ciccarelli Eliano Bonaccorsi-Riani Laurent Coubeau Pierre-Fran?ois Laterre Pierre Goffette chantal.de reyck Beno?t Lengelé Pierre Gianello Jan Lerut Starzl Abdominal Transplant Unit Cliniques Universitaires Saint-Luc Institut de Recherche Expérimentale et Clinique Université catholique de Louvain department of Biotechnological and Applied Clinical Sciences University of L’Aquila Hepatobiliopancreatic Unit Las Higueras Hospital Cirugía de Trasplantes Centro Médico Imbanaco department of Intensive Care Cliniques Universitaires Saint-Luc Université catholique de Louvain department of Radiology Cliniques Universitaires Saint-Luc Université catholique de Louvain department of Plastic and Reconstructive Surgery Cliniques Universitaires Saint-Luc Université catholique de Louvain P?le de Chirurgie Expérimentale et Transplantation Institut de Recherche Expérimentale et Clinique Université catholique de Louvain

Background: Liver transplantation is the treatment for end-stage liver diseases and well-selected malignancies. The allograft shortage may be alleviated with living donation. The initial UCLouvain experience of adult living-donor liver transplantation(LDLT) is presented. Methods: A retrospective analysis of 64 adult-to-adult LDLTs performed at our institution between 1998 and 2016 was conducted. The median age of 29(45.3%) females and 35(54.7%) males was 50.2 years(interquartile range, IQR 32.9–57.5). Twenty-two(34.4%) recipients had no portal hypertension. Three(4.7%) patients had a benign and 33(51.6%) a malignant tumor [19(29.7%) hepatocellular cancer, 11(17.2%) secondary cancer and one(1.6%) each hemangioendothelioma, hepatoblastoma and embryonal liver sarcoma]. Median donor and recipient follow-ups were 93 months(IQR 41–159) and 39 months(22–91), respectively. Results: Right and left hemi-livers were implanted in 39(60.9%) and 25(39.1%) cases, respectively. Median weights of right-and left-liver were 810 g(IQR 730–940) and 454 g(IQR 394–534), respectively. Graft-to-recipient weight ratios(GRWRs) were 1.17%(right, IQR 0.98%-1.4%) and 0.77%(left, 0.59%-0.95%). One-and five-year patient survivals were 85% and 71%(right) vs. 84% and 58%(left), respectively. Oneand five-year graft survivals were 74% and 61%(right) vs. 76% and 53%(left), respectively. The patient and graft survival of right and left grafts and of very small( developed a Clavien–Dindo complication IIIa, IIIb or IV. Recipient morbidity consisted mainly of biliary and vascular complications; three(4.7%) recipients developed a small-for-size syndrome according to the Kyushu criteria. Conclusions: Adult-to-adult LDLT is a demanding procedure that widens therapeutic possibilities of many hepatobiliary diseases. The donor procedure can be done safely

关键词： Liver transplantation Living-donor Hepatocellular cancer Secondary liver tumor Small-for-size syndrome Small-for-size graft

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