title: Living donor liver transplantation using grafts with hepatic cysts.
abstract: Cystic lesions in the liver are often found through the evaluation of liver donors. Multiple cysts are worrisome, and donor candidates with multiple cysts may be unacceptable as liver donors, especially when their recipients have fibrocystic disease (FCD), which is an inherited disorder. This study reviewed 183 cases of living donor liver transplantation. We collected clinical and radiological data associated with donors with cystic lesions and with donors without cystic lesions, and we evaluated the outcomes of these donors and their recipients. As part of the preoperative radiological assessment of grafts, magnetic resonance cholangiography (MRC) was performed to evaluate the biliary anatomy of donor candidates with multiple cysts. Thirty-four donors (18.6%) had 1 or more cystic lesions in the liver, and 6 of these donors had multiple cysts (ie, >10). Donors with multiple cysts were older and heavier, and there was a significant relationship between these donors and recipients whose original disease was FCD. During the follow-up (median = 3.1 years), all donors with cystic lesions were found to be doing well without any major postoperative complications. Fifteen recipients who received grafts with cystic lesions (12 left-sided lobes and 3 right-sided lobes) had no complications related to the cystic lesions. In conclusion, donors with cystic lesions may be acceptable as liver donors, although our data are limited mostly to left-sided lobe donation with a short follow-up period. MRC should be preoperatively performed to rule out any biliary anomalies, especially in donor candidates whose recipients have FCD.
authors.affiliation: Division of Transplant Surgery, National Center for Child Health and Development, Tokyo, Japan. sakamoto-si@ncchd.go.jp
authors.forename: Seisuke
authors.initials: S
authors.lastname: Sakamoto
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Nosaka
authors.forename: Takanobu
authors.initials: T
authors.lastname: Shigeta
authors.forename: Hajime
authors.initials: H
authors.lastname: Uchida
authors.forename: Ikumi
authors.initials: I
authors.lastname: Hamano
authors.forename: Chiaki
authors.initials: C
authors.lastname: Karaki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kanazawa
authors.forename: Akinari
authors.initials: A
authors.lastname: Fukuda
authors.forename: Atsuko
authors.initials: A
authors.lastname: Nakazawa
authors.forename: Mureo
authors.initials: M
authors.lastname: Kasahara
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D049448:Cholangiopancreatography, Magnetic Resonance; D003560:Cysts / Q000150:complications* / Q000000981:diagnostic imaging; D046148:Donor Selection; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008107:Liver Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D016031:Liver Transplantation / Q000009:adverse effects; D019520:Living Donors / Q000600:supply & distribution*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011859:Radiography; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult