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Clostridium difficile-associated diarrhea after living donor liver transplantation

World Journal of Gastroenterology 2007年第14期13卷 2072-2076页

作者： Masao Hashimoto Yasuhiko Sugawara Sumihito Tamura junichi Kaneko Yuichi Matsui junichi togashi Masatoshi Makuuchi Artificial Organ and Transplantation Division Department of Surgery Graduate School of MedicineUniversity of Tokyo7-3-1 HongoBunkyo-kuTokyo 113-8655Japan

AIM： To assess the incidence and analyze the risk factors for Clostridium difficile-associated diarrhea （CDAD）after living donor liver transplantation （LDLT） in adult.METHODS： The micobiological data and medical records of 242 adult recipients that underwent LDLT at the Tokyo University Hospital were analyzed retrospectively. The independent risk factors for postoperative CDAD were identified.RESULTS： Postoperative CDAD occurred in 11 （5%）patients. Median onset of CDAD was postoperative d 19（range, 5-54）. In the multivariate analyses, male gender （odds ratio, 4.56） and serum creatinine （≥ 1.5 mg/dL,odds ratio, 16.0） independently predicted postoperative CDAD.CONCLUSION： CDAD should be considered in the differential diagnosis of patients with postoperative diarrhea after LDLT.

关键词： Living donor liver transplantation Clostridiumdifficile Diarrhea

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Recurrence of cholestatic liver disease after living donor liver transplantation

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World Journal of Gastroenterology 2008年第33期14卷 5105-5109页

作者： Sumihito Tamura Yasuhiko Sugawara junichi Kaneko junichi togashi Yuichi Matsui Noriyo Yamashiki Norihiro Kokudo Masatoshi Makuuchi Artificial Organ and Transplantation Division Department of Surgery Graduate School of Medicine University of Tokyo7-3-1 Hongo Bunkyo-ku Tokyo 113-8655 Japan Japanese Red Cross Medical Center 4-1-22 Hiroo Shibuya-ku Tokyo 150-8935 Japan

End-stage liver disease, due to cholestatic liver diseases with an autoimmune background such as primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC), is considered a good indication for liver transplantation. Excellent overall patient and graft outcomes, based mostly on the experience from deceased donor liver transplantation (DDLT), have been reported. Due to the limited number of organ donations from deceased donors in most Asian countries, living donor liver transplantation (LDLT) is the mainstream treatment for end-stage liver disease, including that resulting from PBC and PSC. Although the initial experiences with LDLT for PBC and PSC seem satisfactory or comparable to that with DDLT, some aspects, including the timing of transplantation, the risk of recurrent disease, and its long-term clinical implications, require further evaluation. Whether or not the long-term outcomes of LDLT from a biologically related donor are equivalent to that of DDLT requiresfurther observations. The clinical course following LDLT may be affected by the genetic background shared between the recipient and the living related donor.

关键词： Liver transplantation Primary biliary cirrhosis Primary sclerosing cholangitis Living donor Recurrence

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