title: Hepatic copper concentration in children undergoing living related liver transplantation due to Wilsonian fulminant hepatic failure.
abstract: Liver transplantation is indicated for Wilson's disease (WD) patients having the fulminant form and end-stage liver failure. To evaluate whether living related liver transplantation (LRLT) can correct the copper metabolism in WD patients, we studied two children who underwent LRLT because of fulminant hepatic failure. They were 7 and 13 yrs old at the time LRLT was performed. Serum ceruloplasmin levels, serum copper levels, copper urine excretion, and hepatic copper concentrations were measured. Serum ceruloplasmin levels (16.7 +/- 1.2 mg/dL) and serum copper levels (67.0 +/- 1.4 microg/dL) were lower than the normal range after LRLT in case 1. In both patients, urinary copper excretion was reduced markedly after LRLT, but was not normalized (case 1, 191.2 +/- 182.2 microg/d; case 2, 140.0 +/- 156.7 microg/d). Hepatic copper concentrations were slightly elevated (case 1, 158.8 +/- 44.6 microg/g dry weight; case 2, 147.0 microg/g dry weight) after LRLT in both cases, but did not exceed 250 microg/g dry weight. LRLT is a curative procedure in Wilson's disease presenting fulminant hepatic failure or advanced cirrhosis. However, this study indicates that the conditions of copper metabolism in WD patients undergoing LRLT are similar to those in heterozygous genetic carriers. Because the living related donors are the parents who carry the abnormal gene, LRLT cannot completely restore the copper balance in WD patients.
authors: Department of Pediatrics, National Defense Medical College, Tokorozawa City, Saitama, Japan. grd1303@gr.ndmc.ac.jp
authors: Haruki
authors: H
authors: Komatsu
authors: Tomoo
authors: T
authors: Fujisawa
authors: Ayano
authors: A
authors: Inui
authors: Tsuyoshi
authors: T
authors: Sogo
authors: Isao
authors: I
authors: Sekine
authors: Hiroko
authors: H
authors: Kodama
authors: Shinji
authors: S
authors: Uemoto
authors: Koichi
authors: K
authors: Tanaka
mesh_terms: D000293:Adolescent; D002648:Child; D003300:Copper / Q000032:analysis*; D006527:Hepatolenticular Degeneration / Q000150:complications* / Q000378:metabolism / Q000601:surgery; D006801:Humans; D008099:Liver / Q000737:chemistry*; D017093:Liver Failure / Q000209:etiology / Q000378:metabolism / Q000601:surgery*; D016031:Liver Transplantation; D019520:Living Donors
chemical_list: D003300:Copper