title: Right-lobe living-donor liver transplantation in adult patients with acute liver failure.
abstract: BACKGROUND
  Right-lobe living-donor liver transplantation (RLDLT) is an excellent option to reduce donor shortages for adult patients with acute liver failure (ALF). The aim of this study was to evaluate the etiologies and outcomes of 30 consecutive adult patients who underwent emergency RLDLT for ALF.
  
  
  METHODS
  Between January 2007 and September 2011, we examined data from medical records of patients with ALF who underwent RLDLT.
  
  
  RESULTS
  Their mean age was 32.2 ± 13.05 years. The etiologies of ALF were acute hepatitis B (n = 11; 36.6%), hepatitis A (n = 4; 13.3%), drug intoxication (n = 4; 13.3%), pregnancy (n = 2; 6.7%), hepatitis B with pregnancy (n = 1; 3.3%), mushroom intoxication (n = 1; 3.3%), and unknown (n = 7; 23.3%). The mean hepatic coma grade (Model for End-Stage Liver Disease score) was 34.13 ± 8.72. The 43 (48.7%) postoperative complications were minor (grades I-II) and 44 (51.3%) were major (grades III-V). Reoperation was required in 14 of 30 (47%) recipients (grades IIIb-IVa). Deaths occurred owing to pulmonary (n = 2), cardiac (n = 1), septic (n = 2), or encephalopathic (n = 4) complications. The mean durations of intensive care unit stay and postoperative hospitalization were 3.2 ± 2.3 and 29.5 ± 23 days, respectively. The survival rate was 70%. The mean follow-up duration was 305 days (range, 1-1582).
  
  
  CONCLUSIONS
  Liver transplantation is potentially the only curative modality, markedly improving the prognosis of patients with ALF. The interval between ALF onset and death is short and crucial because of the rapid, progressive multiorgan failure. Thus, RLDLT should be considered to be a life-saving procedure for adult patients with ALF, requiring quicker access to a deceased-donor liver graft and a short ischemia time.
authors.affiliation: Department of General Surgery, Inonu University, School of Medicine, Malatya, Turkey. drmustafaates@hotmail.com
authors.forename: M
authors.initials: M
authors.lastname: Ates
authors.forename: S
authors.initials: S
authors.lastname: Hatipoglu
authors.forename: A
authors.initials: A
authors.lastname: Dirican
authors.forename: B
authors.initials: B
authors.lastname: Isik
authors.forename: V
authors.initials: V
authors.lastname: Ince
authors.forename: M
authors.initials: M
authors.lastname: Yilmaz
authors.forename: C
authors.initials: C
authors.lastname: Aydin
authors.forename: C
authors.initials: C
authors.lastname: Ara
authors.forename: C
authors.initials: C
authors.lastname: Kayaalp
authors.forename: S
authors.initials: S
authors.lastname: Yilmaz
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D017114:Liver Failure, Acute / Q000601:surgery*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D055815:Young Adult