Adult-to-adult living-donor liver transplantation. A summary of current status and an outline of the program in Geneva.

Living donor liver transplantation is a relatively new procedure in which the right side of the liver is harvested in a healthy donor and transplanted into a recipient. After the first case in 1994, over 3000 cases have been done worldwide. This review summarizes the reasons why the procedure is needed, describes its main technical aspects, highlights the boundaries in which it can be done safely, summarizes the current experience worldwide and describes the main points of the program in our unit. We argue that living-donor transplantation is a viable alternative to a long time on the waiting list for several patients, and it can be performed safely and successfully provided that all precautions are undertaken to minimize the risks in the donor and to increase the chances of a good outcome in the recipients. If these prerequisites are met, and within the framework of a structured multidisciplinary program, we believe that living-donor liver transplantation should be funded by health insurances as a recognized therapeutic option.

Serum apolipoprotein A-II, a biochemical indicator of alcohol abuse.

The possible use of high density lipoprotein (HDL) cholesterol, HDL phospholipids, apolipoproteins (APO) A-I and A-II as markers of alcohol abuse was studied in 78 intemperate drinkers. The mean value for each of these parameters was higher in drinkers than in control subjects. The most significant increase was observed in the plasma apo A-II levels (+45%). A composite index of gammaglutamyltranspeptidase (GGTP) and apo A-II was superior to GGTP alone in discriminating drinkers (+14%). Moreover, apo A-II assay is simple to perform.