Feasibility of using a liver infected with Clonorchis sinensis for liver transplantation: fourteen cases.
Use of livers infected with Clonorchis sinensis as donor organs for transplantation is controversial because of the potential associated risks. The low availability of donor livers at Tianjin First Center Hospital since 2003 prompted us to undertake cadaveric liver transplantation in 14 patients using donor livers infected with C. sinensis. None of the donors had been diagnosed with liver fluke infection before organ procurement, and in none of them was there laboratory evidence of abnormal liver function. After livers had been harvested and preserved, dead liver flukes were found in the bile of each donor; subsequent pathological examination of the flukes confirmed the diagnosis of clonorchiasis. Conventional orthotopic liver transplantation, with insertion of a T- tube, was undertaken in all 14 patients. Praziquantel, 25 mg/kg three times daily for two days, was administrated to the recipients starting on postoperative day 2. Results of tests of liver function improved rapidly after the operation in all of the patients. The median duration of follow-up was 31 months. The 1- and 3-year survival rates of the grafts were 85.7% and 78.6%, respectively. Postoperative biliary complications occurred in 2 patients (14.3%). No ova were detected in the bile or feces of any of the patients postoperatively. These findings suggest that livers infested with C. sinensis can be used as donor organs for liver transplantation. Further studies are required to establish definitive criteria for determining whether such donor organs may be used in a liver transplantation program.
Transplant Center, Tianjin First Central Hospital, Tianjin, China.
Zhi-Jun
ZJ
Zhu
Zhong-Yang
ZY
Shen
Wei
W
Gao
Hong
H
Zheng
Yong-Lin
YL
Deng
Cheng
C
Pan
Li-Ying
LY
Sun
Zhi-Gui
ZG
Zeng
Ji-San
JS
Sun
D000328:Adult; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D003003:Clonorchiasis / Q000150:complications / Q000188:drug therapy; D003004:Clonorchis sinensis / Q000302:isolation & purification*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology; D006801:Humans; D008099:Liver / Q000469:parasitology*; D008107:Liver Diseases / Q000601:surgery*; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011223:Praziquantel / Q000627:therapeutic use; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
D000871:Anthelmintics; D011223:Praziquantel