Impact of donor age and recipient status on left-lobe graft for living donor adult liver transplantation.
Donor safety is the priority when performing a living donor adult liver transplantation (LDALT). We herein present our findings using left-lobe graft in LDALT. Data on 119 recipients who underwent the LDALT, and on 119 donors who underwent extended left lobectomy were reviewed. The recipients were divided into groups above (n = 19) and below (n = 100) 50 years of donor age, into groups above (n = 63) and below (n = 56) 40% of graft size (graft volume/standard liver volume, GV/SLV), and above (n = 25) and below (n = 94) 20 of pre-operative model for end-stage liver disease (MELD). Total bilirubin (TB), volume of ascites, prothrombin time international normalized ratio on postoperative day 14 or survival rates were compared. TB (mg/dl) or volume of ascites (ml) of the group in donor age < 50 years was better than that of the group in donor age > or = 50 years (7.4 vs. 14.7 or 788 vs. 1379, P < 0.001 or P < 0.005, respectively). The graft and patient survival rates of the lower MELD group tended to be better than that of the higher MELD group. LDALT can be safely performed using a left-lobe graft. However, when using the graft from the donor > or = 50 years, especially for the recipients with the MELD > or = 20, the indications should be carefully discussed.
Yoshizumi
Tomoharu
T
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Taketomi
Akinobu
A
Soejima
Yuji
Y
Uchiyama
Hideaki
H
Ikegami
Toru
T
Harada
Noboru
N
Kayashima
Hiroto
H
Yamashita
Yo-Ichi
Y
Shimada
Mitsuo
M
Maehara
Yoshihiko
Y
D000328:Adult; D000367:Age Factors; D000368:Aged; D005234:Fatty Liver / Q000150:complications / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D017093:Liver Failure / Q000209:etiology / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods* / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009929:Organ Size / Q000502:physiology*; D018579:Patient Selection; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome