Left-liver Adult-to-Adult Living Donor Liver Transplantation: Can It Be Improved? A Retrospective Multicenter European Study
| Autor: | Antonio Sa Cunha, Thierry Berney, Nikdokht Rashidian, Josep Fuster, Aude Vanlander, Constantino Fondevila, Christian Toso, Pietro Majno, Laure Elkrief, Daniel Cherqui, Xavier Rogiers, Denis Castaing, Gabriella Pittau, Roberto Troisi, Bernard de Hemptinne, René Adam, Juan Carlos García-Valdecasas, Santiago Sánchez-Cabús |
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| Přispěvatelé: | Sánchez-Cabús, Santiago, Cherqui, Daniel, Rashidian, Niki, Pittau, Gabriella, Elkrief, Laure, Vanlander, Aude, Toso, Christian, Fondevila, Constantino, Cunha, Antonio Sa, Berney, Thierry, Castaing, Deni, de Hemptinne, Bernard, Fuster, Josep, Rogiers, Xavier, Adam, René, Majno, Pietro, García-Valdecasas, Juan Carlo, Troisi, Roberto I |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Left liver 030230 surgery Liver transplantation 03 medical and health sciences 0302 clinical medicine Postoperative Complications Hepatic lobectomy Liver Function Tests Risk Factors medicine Graft selection Living Donors Humans Laparoscopy Retrospective Studies ddc:617 medicine.diagnostic_test business.industry Background data Graft Survival Middle Aged Surgery Liver Transplantation Europe Treatment Outcome 030211 gastroenterology & hepatology Female Right liver business Living donor liver transplantation |
| Zdroj: | Annals of Surgery, Vol. 268, No 5 (2018) pp. 876-884 |
| ISSN: | 0003-4932 |
| Popis: | OBJECTIVE: To evaluate the European experience after Adult-to-adult living donor liver transplantation using the left liver (LL-aLDLT). SUMMARY BACKGROUND DATA: LL-aLDLT decreases donor risk but provides a smaller graft that increases recipient risk as compared with right liver (RL-aLDLT). However, there is little knowledge of results obtained after LL-aLDLT in Europe. METHODS: This is a European multicenter retrospective study which aims to analyze donor and recipient outcomes after 46 LL-aLDLT. RESULTS: Seventy-six percent of the grafts were harvested by minimally invasive approach. Mean donor hospital stay was 7.5 ± 3.5 days. Donor liver function was minimally impaired, with 36 donors (78.3%) without any 90-day complication, and 4 (8.7%) presenting major complications. One, 3, and 5-year recipient survival was 90.9%, 82.7%, and 82.7%, respectively. However, graft survival was of 59.4%, 56.9%, and 56.9% at 1, 3, and 5 years respectively, due to a 26.1% urgent liver retransplantation (ReLT) rate, mainly due to SFSS (n = 5) and hepatic artery thrombosis (HAT, n = 5). Risk factor analysis for ReLT and HAT showed an association with a graft to body weight ratio (GBWR) 0.6% was associated with a lower ReLT rate (0% vs. 33%, P = 0.044). CONCLUSIONS: Our analysis showed low donor morbidity and preserved liver function. Recipient outcomes, however, were hampered by a high ReLT rate. A strict selection of both donor and recipients is the key to minimize graft loss. |
| Databáze: | OpenAIRE |
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