Living donor liver transplantation for hepatitis B virus related acute or subacute liver failure / 中华消化外科杂志

ABSTRACT

Objective To investigate the feasibility and evaluate the outcome of living donor.liver transplantation(LDLT) for hepatitis B virus(HBV)related acute liver failure(ALF)or subacute liver failure (SALF).Methods A retrospective analysis was done based on the clinical data of 10 patients with ALF or SALF who underwent LDLT from November 2000 to October 2007. All the liver grafts,including right lobe with middle hepatic vein(MHV)(n=8)and right lobe without MHV(n=2),were obtained from adult donors.The Drocess of donor evaluation was accomplished within 12 hours after making the decision of LDLT, and the donor and recipient operation was performed within 12 hours after signing the donor informed consent.The mean graft recipient weight ratio was(1.03±0.17)%(ranged from 0.86%to 1.22%),and graft volume to standard liver volume ratio was(52.2±11.8)%(ranged from 47.6%to 70.1%).Results Two recipients died of pulmonary infection and duodenal ulcer perforation on postoperative day 7 and 28,respectively.The rest 8 recipients were alive and well with a median 9.6 months(ranged from 2 to 84 months)follow-up.The postoperative complications included bile leakage in 1 recipient and acute cellular rejection in 2 recipients.No donor mortality occurred.One donor received splenectomy due to spleen rupture caused by acute portal hypertension. No complications was found in the 0ther 9 donors. Conclusions LDLT is an effective and safe option for HBV related ALF and SALF for the high median to long term survival rate.