[Adult living donor liver transplantation. Analysis of the first 30 cases].
BACKGROUND
In the last 2-3 years, adult living donor liver transplantation (ALDLT) has been developed on an international scale, multiplying the number of procedures performed. Despite this, analysis of the results is still incomplete. The aim of the present study was to perform a descriptive analysis of the results after the first 3 years of the initiation of the program.


METHODS
During this period, 30 ALDLT were performed. In all procedures, right lobe grafts were used. The mean age of donors and recipients was 31.8 and 52.7 years, respectively. The main indication for liver transplantation was liver cirrhosis due to hepatitis C virus (70%) and 38% of recipients were stage C in the Child-Pugh classification. A total of 46.7% of recipients had hepatocellular carcinoma.


RESULTS
Donors: The mean volume of the remnant liver was 632 cc (40.5% of the previous hepatic mass). Ten donors (33%) presented complications. The most frequent complication was biliary fistula (20%) and three patients required reintervention. The mean length of hospital stay among donors was 11.7 days. Recipients: The mean weight of the graft was 775 g, with a mean difference between graft weight and that of the recipient of 1.11. Fifteen recipients (50%) presented biliary leaks and nine of these (30%) required reintervention. There were no graft losses for technical reasons. Four patients died. With a median follow-up of 14 months, actuarial survival at 18 months was 92.9%.


CONCLUSIONS
ALDLT is an effective method for reducing the number of patients on the waiting list. The probability of survival is similar to that of cadaveric transplantation. Biliary complications in the recipient constitute a problem, the long-term repercussions of which remain to be resolved.
García-Valdecasas
J C
JC
Sección de Cirugía Hepática y Trasplante, Institut de Malalties Digestives, Hospital Clínic, Universidad de Barcelona, Barcelona, España. jcvalde@medicina.ub.es
Fuster
J
J
Charco
R
R
Bombuy
E
E
Fondevila
C
C
Navasa
M
M
Rodríguez-Laiz
G
G
Ferrer
J
J
Amador
M A
MA
Llovet
J M
JM
Forns
X
X
Rimola
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006498:Hepatectomy; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D013997:Time Factors