ABSTRACT
HIV infections have always been a stigma, and the majority of transplant centres avoid liver transplantation in patients having end-stage liver disease patients with HIV coinfection. HIV patients with end-stage liver disease having undetectable HIV viral load, CD4+ cell count of >100/ml, and negative history of AIDS-specific opportunistic infections are considered suitable candidates for liver transplantation. Fulfilling the above-mentioned criteria, we performed successful living donor liver transplantation (LDLT) procedure on a 58-year-old gentleman who presented with end-stage liver disease and HIV coinfection. Key Words: HIV, Living donor, Liver transplantation.
Subject(s)
End Stage Liver Disease , HIV Infections , Liver Transplantation , Humans , Middle Aged , End Stage Liver Disease/complications , End Stage Liver Disease/surgery , HIV Infections/complications , Living DonorsABSTRACT
BACKGROUND: The literature lacks data on World Health Organization (WHO) class II and III deficient liver donors who underwent right hepatectomy during living donor liver transplantation (LDLT). METHODS: In this prospective cohort study, we compared the perioperative outcomes of 15 glucose-6 phosphate dehydrogenase (G6PD) deficient living liver donors with a matched cohort of 39 nondeficient living liver donors undergoing right lobe donation. RESULTS: Out of 15 G6PD deficient donors, four (26.67%) donors had class II, and 11 (73.34%) had class III G6PD deficiency. The mean postoperative trough hemoglobin level was significantly lower in the deficient group than the nondeficient group (9.38 ± 1.59 g/dL vs. 10.27 ± .91 g/dL, p = .046). The mean peak indirect bilirubin level was significantly higher in the deficient group than the nondeficient group (2.22 ± 1.38 mg/dL vs. 1.40 ± .89 mg/dL, p = .047), and a similar trend was observed in total serum bilirubin (3.99 ± 2.57 mg/dL vs. 2.99 ± 1.46 mg/dL, p = .038). Biochemical evidence of hemolysis was found only in three (20%) deficient donors, but none of them needed a blood transfusion. No mortality was observed in either group. All other parameters, including demographics, operative parameters, graft characteristics, and hospital stay were comparable between both groups (p > .05). CONCLUSION: G6PD deficiency with WHO class II and above should not be considered a contraindication for right lobe donation.
