title: [Clinical study of adult to adult living donor liver transplantation: a report of 56 cases].
abstract: OBJECTIVE
  To investigate the ways to ensure the safety of donors and recipients in adult-to-adult living donor liver transplantation (A-ALDLT).
  
  
  METHODS
  From January 2002 to September 2006, 56 A-ALDLT were performed in our division, including 52 cases of right lobe graft were obtained without medial hepatic vein (MHV) and 4 cases of dual grafts (1 case using two left lobes, 3 cases using 1 right and 1 left lobe). The most common diagnoses were hepatitis B liver cirrhosis (62.5%) and hepatocellular carcinoma (30.4%) in recipients. Among them, 10 cases scored more than 25 with the model of end-stage liver disease (MELD) scoring system. Triphasic liver computed tomography were used for reconstruction of hepatic vessels and to calculate total liver and right liver volumes in donors. Various innovative surgical techniques were adopted too.
  
  
  RESULTS
  From the 58 living donors, 55 right lobes and 3 left lobes were obtained. The 55 right lobe grafts were obtained without medial hepatic vein, weighed 400 approximately 860 g (median 550 g). The ratio of graft volume to recipient standard liver volume ranged from 31.7% to 71.7% (median 45.4%). All donors' remnant liver volumes were over 35% of the total liver volume. There was no donor mortality, but 7 (12.5%) donors experienced complications. Of the 56 recipients, with a follow-up period of 2 approximately 52 months (median 11 months), 15 (26.8%) developed complications and 4 (7.2%) died within 3 months post operation. The 1-year actual survival rate was 92.8%.
  
  
  CONCLUSIONS
  When preoperative CT volume shows remnant liver volume is greater than 35% of the total liver volume, and graft volume to recipient's standard liver volume ratio is over 40%, A-ALDLT using right lobe graft is a safe procedure for both donors and recipients, otherwise the dual graft liver transplantation should be considered.
authors.affiliation: Transplantation Division, Department of Surgery, West China Hospital, Sichuan University, Chengdu, China. yanlunan688@163.com
authors.forename: Lü-nan
authors.initials: LN
authors.lastname: Yan
authors.forename: Bo
authors.initials: B
authors.lastname: Li
authors.forename: Yong
authors.initials: Y
authors.lastname: Zeng
authors.forename: Tian-fu
authors.initials: TF
authors.lastname: Wen
authors.forename: Wen-tao
authors.initials: WT
authors.lastname: Wang
authors.forename: Jia-yin
authors.initials: JY
authors.lastname: Yang
authors.forename: Ming-qing
authors.initials: MQ
authors.lastname: Xu
authors.forename: Zhe-yu
authors.initials: ZY
authors.lastname: Chen
authors.forename: Ji-chun
authors.initials: JC
authors.lastname: Zhao
authors.forename: Yu-kui
authors.initials: YK
authors.lastname: Ma
authors.forename: Hong
authors.initials: H
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006503:Hepatic Veins / Q000601:surgery; D006801:Humans; D008107:Liver Diseases / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods* / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D020858:Tissue and Organ Harvesting / Q000379:methods