Outcomes of adult-to-adult living donor liver transplantation: a single center experience.
BACKGROUND
Since January 2002, adult-to-adult living donor liver transplantation (AALDLT) has gained increasing popularity in China in response to the shortage of cadaveric donor livers. This study presents a detailed analysis of the outcomes of AALDLT in a single center.


METHODS
A total of 70 patients underwent AALDLT at our center between January 2002 and January 2007. Among these, 67 patients received a right lobe graft without the middle hepatic vein and 3 patients received dual grafts. Three-dimensional volumetric computed tomography, magnetic resonance imaging with angiography and cholangiography were performed preoperatively. Recipient operation time, intraoperative transfusion requirement, length of intensive care unit stay, length of hospital stay, liver function tests, coagulation tests and surgical outcomes were routinely investigated throughout this study.


RESULTS
All donors survived the procedure with an overall complication rate of 15.3%. Overall recipient 1-year survival and complication rates were 87.1% and 34.2%, respectively. Among the 70 cases, average graft recipient weight ratio was 0.94% (0.72% - 1.43%) and average graft volume/standard liver volume ratio was 46.42% (31.74% - 71.68%). All residual liver volumes exceeded 35%. Liver function and coagulation recovered rapidly within the first 7 days after transplantation.


CONCLUSIONS
AALDLT is a safe procedure for the donors and an effective therapy for patients with end-stage liver disease. Patient selection and timely decision-making for transplantation are essential in achieving good outcomes. With accumulation of experience in surgery and clinical management, timely feedback and proper modification, we foresee better outcomes in the future.
Feng
Xi
X
Center of Liver Transplantation, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
Yuan
Ding
D
Wei
Yong-Gang
YG
Li
Fu-Qiang
FQ
Wen
Tian-Fu
TF
Zeng
Yong
Y
Zhao
Ji-Chun
JC
Wang
Wen-Tao
WT
Xu
Ming-Qing
MQ
Yang
Jia-Yin
JY
Ma
Yu-Kui
YK
Chen
Zhe-Yu
ZY
Ye
Hui
H
Yan
Lü-Nan
LN
Li
Bo
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult