[Adult to adult living donor liver transplantation for decompensated end stage liver disease].
OBJECTIVE
To summarize the clinical experience and some principal surgical techniques of adult to adult living donor liver transplantation (ALDLT).


METHODS
The clinical data of 9 patients receiving ALDLT from September 2000 to September 2004 in liver transplantation center in the First Affiliated Hospital of Nanjing Medical University were analyzed retrospectively. The left lobe (segments II, III, IV, including the middle hepatic veins) was transplanted in 3 patients, and the right lobe (segments V, VI, VII, VIII, not including the middle hepatic veins) was transplanted in 6 patients.


RESULTS
There was no operative death in donors. The median operative time was (6.2+/-1.4) hours. The blood loss ranged from 300 to 1,200 ml. Postoperative complications included biliary fistula (1 donor) and wound fat liquefaction (1 donor). They were followed up for 6-12 months, and no long term complications were found. In recipients, the operating time ranged from 5 to 11 hours. The blood loss ranged from 800 to 7,000 ml. Modified outflow reconstruction method, microvascular reconstruction of the hepatic artery and duct to duct biliary reconstruction were performed in recipients. The median cold ischemic time of the grafts was (1.9+/-0.5) hours. The mean non hepatic stage of recipients was (98+/-26) minutes. Graft/recipient weight ratio (GRWR) was (1.20+/-0.26)%. One recipient presented postoperative complication of biliary fistula. One recipient died of serious infection 1 month postoperatively. The other 8 recipients enjoyed longterm survival.


CONCLUSIONS
The procedure of ALDLT is an effective method in the treatment of decompensated end stage liver disease, and it is relatively safe for the donor. Reconstruction of vessels is the key surgical technique in the operative procedure.
Xu
San-rong
SR
Liver Transplantation Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing 212001, Jiangsu, China.
Wang
Xue-hao
XH
Li
Xiang-cheng
XC
Zhang
Feng
F
Li
Guo-qiang
GQ
Cheng
Feng
F
Wang
Ke
K
Qian
Xiao-feng
XF
Sun
Bei-cheng
BC
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008107:Liver Diseases / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D012189:Retrospective Studies; D055815:Young Adult