Living donor liver transplantation using dual grafts from two donors: a feasible option to overcome small-for-size graft problems?
Living donor liver transplantation (LDLT) between adults inevitably implies two potential risks associated with a small-for-size graft for the recipient and small remnant liver for the donor. To overcome these problems, LDLT using dual grafts from two independent donors can be a solution, in which sufficient graft volume can be obtained while preserving donor safety. We present a case of LDLT that was managed successfully by using right and left lobe dual grafts from two donors. The recipient was a large-size male with hepatitis C cirrhosis complicated by multiple hepatocellular carcinomas (HCCs). The first donor donated a right lobe graft and the second donor donated a left lobe plus caudate lobe graft with the middle hepatic vein. Graft function was excellent throughout the course without evidence of small-for-size syndrome. In conclusion, LDLT using dual grafts can be justified in a selected case to avoid small-for-size graft problems without increasing independent donor risks.
Soejima
Y
Y
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. ysoejima@surg2.med.kyushu-u.ac.jp
Taketomi
A
A
Ikegami
T
T
Yoshizumi
T
T
Uchiyama
H
H
Yamashita
Y
Y
Meguro
M
M
Harada
N
N
Shimada
M
M
Maehara
Y
Y
D000713:Anastomosis, Roux-en-Y; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D006526:Hepatitis C / Q000601:surgery; D006801:Humans; D008099:Liver / Q000033:anatomy & histology*; D017093:Liver Failure / Q000209:etiology / Q000601:surgery; D008113:Liver Neoplasms / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D016896:Treatment Outcome