Adult to adult living-related liver transplant: report on an initial experience in Italy.
BACKGROUND
Living-related liver transplantation has become the treatment of choice for many liver diseases. We present our initial analysis of 53 cases of adult to adult living-related liver transplantation performed in a single institute in Italy.


METHODS
From January 2002 to September 2006, we performed 53 adult to adult living-related liver transplantations. The donors (age 18-53) all had genetic or emotional relationships; they were all ABO identical or compatible. Recipients (ages 18-68) suffered from cirrhosis secondary to viral etiology (18), hepatocellular carcinoma with viral cirrhosis (24), cystic fibrosis (2), primary biliary cirrhosis (2), hepatocellular carcinoma with non-viral cirrhosis (2), alcoholic cirrhosis (1), ornithine transcarbamylase deficiency (OTC), (1) criptogenic cryptogenic cirrhosis, (1) primary sclerosing cholangitis, (1) biliary atresia and metastatic carcinoid (1). Donor liver resection resulted in 51 right hepatectomies and two left hepatectomies. Graft body weight ratio was always above 0.8%; graft implantation was performed with the piggy back technique and, in 43 cases, with the use of veno-venous bypass.


RESULTS
There was neither donor mortality nor need of blood transfusion. Actuarial recipient survival rate at 3 years was 82.66% and graft survival rate was 75.34%. Six patients underwent retransplantation: in four cases due to hepatic artery thrombosis, and in two, due to graft dysfunction. Three patients had one episode each of acute cellular rejection.


CONCLUSIONS
Adult to adult living-related liver transplantation represents a resource to be used in confronting organ shortage, and is a valuable option for decreasing mortality and drop out from the waiting list.
Gruttadauria
S
S
Mediterranean Institute for Transplantation and Advanced Specialized Therapies, University of Pittsburgh Medical Center in Italy, Palermo, Italy. sgruttadauria@ismett.edu
Marsh
J W
JW
Cintorino
D
D
Biondo
D
D
Luca
A
A
Arcadipane
A
A
Vizzini
G
G
Volpes
R
R
Marcos
A
A
Gridelli
B
B
D000293:Adolescent; D000328:Adult; D046148:Donor Selection; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008107:Liver Diseases / Q000401:mortality / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods / Q000706:statistics & numerical data*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D016896:Treatment Outcome