title: Successful adult-to-adult living donor liver transplantation using liver allograft after the resection of hemangioma: A suggestive case for a further expansion of living donor pool.
abstract: BACKGROUND
  Hepatic hemangioma is one of the most common benign liver tumors. There are few published reports regarding liver transplantation using liver allografts with hemangioma.
  
  
  METHODS
  A 45-year-old man was evaluated as a living donor for 19-year-old son with cirrhosis due to hepatic fibrosis. Preoperative investigations revealed 20 and 7mm hemangiomas, at segment 2 (S2) and 4 (S4) respectively. Considering the anatomical relation of S2 hemangioma and Glisson 2, liver graft was designed as left lobe excluded S2 hemangioma by partial resection. Estimated graft recipient weight ratio (GRWR) even after partial resection of hemangioma was reasonable. During the donor operation, a partial hepatic resection of S2 hemangioma was performed. Intraoperative pathologic findings revealed a cavernous hemangioma, and then, the left hepatic graft with the caudate lobe was harvested. Actual GRWR was 0.90%. Donor's postoperative course was uneventful. Recipient's post-operative course was almost uneventful. Postoperative computed tomography of the recipient showed the graft regeneration without increase or recurrence of hemangioma.
  
  
  CONCLUSIONS
  Organ shortage is a major concern in the field of liver transplantation. A novel donor source with a further option is extremely crucial for a guarantee of liver transplantation. We experienced the first case of adult-to-adult living donor liver transplantation using liver allograft after the resection of hemangioma.
  
  
  CONCLUSIONS
  We advocate that the use of liver allograft with hemangiomas in adult-to-adult LDLT settings can be remarkable strategy to reduce the problem of organ shortage without any unfavorable consequences in both living donor and recipient.
authors.affiliation: Department of Transplantation Surgery, Nagoya University Hospital, Nagoya, Japan. Electronic address: onishiy@med.nagoya-u.ac.jp.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Onishi
authors.affiliation: Department of Transplantation Surgery, Nagoya University Hospital, Nagoya, Japan.
authors.forename: Hideya
authors.initials: H
authors.lastname: Kamei
authors.affiliation: Department of Transplantation Surgery, Nagoya University Hospital, Nagoya, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Imai
authors.affiliation: Department of Transplantation Surgery, Nagoya University Hospital, Nagoya, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Kurata
authors.affiliation: Department of Transplantation Surgery, Nagoya University Hospital, Nagoya, Japan.
authors.forename: Tomohide
authors.initials: T
authors.lastname: Hori
authors.affiliation: Department of Transplantation Surgery, Nagoya University Hospital, Nagoya, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ogura
keywords: Adult-to-adult; Donor pool; Hemangioma; Liver graft; Liver transplantation; Living donor