Impact of donor age and recipient status on left-lobe graft for living donor adult liver transplantation
Impact of donor age and recipient status on left-lobe graft for living donor adult liver transplantation
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DOI：
10.1111/j.1432-2277.2007.00561.x
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发表时间：
2008-01-01
影响因子：
3.1
通讯作者：
Maehara, Yoshihiko
中科院分区：
文献类型：
--
作者：
Yoshizumi, Tomoharu;Taketomi, Akinobu;Maehara, Yoshihiko
进行活体成人肝移植 (LDALT) 时，捐献者的安全是首要任务。我们在此介绍我们在 LDALT 中使用左叶移植物的发现。对 119 名接受 LDALT 的受者和 119 名接受扩大左肺叶切除术的捐赠者的数据进行了审查。受者被分为供体年龄高于（n = 19）和低于（n = 100）50岁的组、高于（n = 63）和低于（n = 56）移植物尺寸（移植物体积/标准肝脏体积，GV/SLV）40％的组，以及高于（n = 25）和低于（n = 94）20岁终末期肝病（MELD）术前模型的组。比较术后第 14 天的总胆红素 (TB)、腹水量、凝血酶原时间国际标准化比值或生存率。供体年龄 < 50 岁组的 TB（mg/dl）或腹水量（ml）优于供体年龄 >= 50 岁组（分别为 7.4 vs. 14.7 或 788 vs. 1379，P < 0.001 或 P < 0.005）。较低 MELD 组的移植物和患者存活率往往优于较高 MELD 组。 LDALT 可以使用左叶移植物安全地进行。然而，当使用年龄≥50岁的供者的移植物时，特别是对于MELD≥20的受者，应仔细讨论适应症。
Donor safety is the priority when performing a living donor adult liver transplantation (LDALT). We herein present our findings using left-lobe graft in LDALT. Data on 119 recipients who underwent the LDALT, and on 119 donors who underwent extended left lobectomy were reviewed. The recipients were divided into groups above (n = 19) and below (n = 100) 50 years of donor age, into groups above (n = 63) and below (n = 56) 40% of graft size (graft volume/standard liver volume, GV/SLV), and above (n = 25) and below (n = 94) 20 of pre-operative model for end-stage liver disease (MELD). Total bilirubin (TB), volume of ascites, prothrombin time international normalized ratio on postoperative day 14 or survival rates were compared. TB (mg/dl) or volume of ascites (ml) of the group in donor age < 50 years was better than that of the group in donor age >= 50 years (7.4 vs. 14.7 or 788 vs. 1379, P < 0.001 or P < 0.005, respectively). The graft and patient survival rates of the lower MELD group tended to be better than that of the higher MELD group. LDALT can be safely performed using a left-lobe graft. However, when using the graft from the donor >= 50 years, especially for the recipients with the MELD >= 20, the indications should be carefully discussed.