[Adult to adult living-related liver transplantation. The Paul-Brousse Hospital preliminary experience].
OBJECTIVE
Liver-graft shortages justify the development of adult living-related liver transplantation. The preliminary experience with this technique at Paul-Brousse Hospital is reported. PATIENTS ET METHODES: From January to July 2000, 7 adult to adult living-related liver transplantations were performed. Donors were 5 females and 2 males aged 20 to 53 years old (median: 41). A right liver graft was harvested in all cases. Recipients were 5 males and 2 females aged from 17 to 58 years old (median: 50) transplanted for viral cirrhosis (4 cases including 2 with hepatocellular carcinoma), subfulminant hepatitis (1 case), hepatocellular carcinoma on a healthy liver (1 case), and epithelioid hemangioendothelioma (1 case). Follow-up ranged from 41 to 157 days (median: 117 days).


RESULTS
One donor had a biliary fistula that healed spontaneously. One donor had asterixis for 24 hours. The 7 donors are alive at home without any late complications. One recipient was retransplanted for hepatic artery thrombosis and 2 recipients had a biliary fistula that healed spontaneously. The 7 recipients are alive at home with normal liver function.


CONCLUSIONS
Our experience and other reports suggest that adult to adult living-related liver transplantation is feasible with rare mortality and low morbidity in donors. Results in recipients are comparable to those obtained with cadaveric grafts. For a given patient the possibility of living related donation might extend the indications for transplantation without penalizing patients waiting for a cadaveric graft.
Azoulay
D
D
Centre Hépato-Biliaire, Hôpital Paul-Brousse, UPRES 1596, IFR 89.9, Université Paris-Sud, Villejuif, France. daniel.azoulay@pbr.ap-hop-paris.fr
Castaing
D
D
Adam
R
R
Savier
E
E
Smail
A
A
Veilhan
L A
LA
Samuel
D
D
Féray
C
C
Saliba
F
F
Ichai
P
P
Roche
B
B
Duclos-Vallée
J C
JC
Bismuth
H
H
D000293:Adolescent; D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery / Q000821:virology; D008113:Liver Neoplasms / Q000601:surgery; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications