[Emergency right lobe adult-to-adult live-donor liver transplantation for the treatment of acute liver failure following severe hepatitis].
OBJECTIVE
To research the clinical feasibility of emergency right lobe adult-to-adult live-donor liver transplantation in treating acute liver failure following severe hepatitis.


METHODS
Consecutive ten severe hepatitis patients (4 acute-on-chronic severe hepatitis and 6 acute severe hepatitis; 9 caused by HBV and 1 with drug-induced acute liver failure) underwent emergency right lobe adult-to-adult live-donor liver transplantation in our hospital from April 2007 to December 2007. The +/- s of model for end-stage liver disease score was 33.22 +/- 6.55. The outcomes of these recipients were prospectively analyzed.


RESULTS
Among them, 8 ABO blood group were identical and 2 compatible. One was Rh sub-group negative. Except 2 recipients died (1 acute renal failure caused by veno cava thrombosis, 1 liver graft lose caused by hepatic artery thrombosis), the rest of recipients (80%) and all donors were safe. The mean graft-to-recipient weight ratio was (1.19 +/- 0.14)%, and graft volume to recipient estimated standard liver volume ratio was (65.13 +/- 8.75)%. Right lobe grafts with middle hepatic vein (MHV) 3 cases, without MHV 4 cases, without MHV but followed by V and VIII hepatic vein outflow reconstruction 3 cases. Encouraging outcome was achieved in this group of recipient: elevated serum creatinine, serum endotoxin, decreased serum prothrombin activity (PTA) and total bilirubin returned to normal about on postoperative day (POD) 3, POD 7, POD 14 and POD 28, respectively.


CONCLUSIONS
Outcomes of emergency right lobe adult-to-adult live-donor liver transplantation for acute hepatic failure following severe hepatitis are fairly encouraging and acceptable. emergency right lobe adult-to-adult live-donor liver transplantation is an effective and life-saving modality for acute liver failure following severe hepatitis.
Lu
Shi-chun
SC
Hepatobiliary Surgery Department and Liver Transplant Center, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China. lsc620213@yahoo.com.cn
Dai
Jun
J
Wang
Meng-long
ML
Zhang
Zhen
Z
Lai
Wei
W
Wu
Ju-shan
JS
Lin
Dong-dong
DD
Guo
Qing-liang
QL
Li
Ning
N
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006505:Hepatitis / Q000150:complications; D006801:Humans; D017114:Liver Failure, Acute / Q000209:etiology / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome