Minimum graft volume for successful adult-to-adult living donor liver transplantation for fulminant hepatic failure.
The major limitation of adult-to-adult living donor liver transplantation is the adequacy of the size of the graft that can be safely harvested from the donor. The present report describes a 22-year-old woman with stage 4 hepatic coma due to fulminant hepatic failure who was successfully treated using a small-for-size left lobe graft from her father. The graft weight was 0.6% of the recipient's body weight, or 25% of her ideal liver weight. Avoidance of warm ischemia, short cold ischemic time, and early treatment of rejection are important elements in optimizing small-for-size graft function. Since the left lobe represents 23-36% of the total liver volume of an adult, it is possible, in most cases, to harvest a left lobe graft of adequate size from a donor of similar size as the recipient.
Lo
C M
CM
Department of Surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Fan
S T
ST
Chan
J K
JK
Wei
W
W
Lo
R J
RJ
Lai
C L
CL
D000328:Adult; D005260:Female; D006501:Hepatic Encephalopathy / Q000601:surgery*; D006801:Humans; D008099:Liver / Q000033:anatomy & histology*; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009929:Organ Size / Q000502:physiology; D014019:Tissue Donors