Successful pediatric living donor liver transplantation from carrier to carrier of hereditary butyrylcholinesterase variant.
Hypocholinesterasemia is often observed clinically, especially in various liver diseases. Not well known, however, is the fact that some patients have a hereditary BChE variant. Little has been reported on liver transplants associated with this hereditary BChE variant. Furthermore, no cases have been reported of a LDLT involving hereditary BChE variant that had been diagnosed preoperatively. A 23-month-old girl who had had a failed Kasai operation for biliary atresia underwent a liver transplant using as a graft her father's lateral segment. Preoperatively, she had been diagnosed with hypocholinesterasemia. As the donor, her father had undergone a preoperative examination, during which he was found to also have hypocholinesterasemia. DNA sequencing revealed that both had the hereditary BChE variant. The unique mutation caused a frame-shift mutation. Variant K was also detected. The patient was discharged 143 days after the operation and has had no problems with immunosuppression since. In conclusion, we report that the hereditary BChE variant is not a contraindication for either transplantation or living liver donation.
Department of Transplant Surgery, Jichi Medical University, Tochigi, Japan. y-kawano@jichi.ac.jp
Youichi
Y
Kawano
Koichi
K
Mizuta
Shuji
S
Hisikawa
Takeshi
T
Saito
Satoshi
S
Egami
Yuka
Y
Takatsuka
Yukihiro
Y
Sanada
Takehito
T
Fujiwara
Yoshikazu
Y
Yasuda
Masami
M
Ohmori
Koichi
K
Sakamoto
Weidong
W
Liu
Shuhei
S
Nishiguchi
Toshikazu
T
Hada
Hideo
H
Kawarasaki
D002091:Butyrylcholinesterase / Q000145:classification* / Q000235:genetics*; D005260:Female; D006579:Heterozygote; D006801:Humans; D007223:Infant; D016031:Liver Transplantation; D019520:Living Donors
D002091:Butyrylcholinesterase