Live donor liver transplantation for acute liver failure
Live donor liver transplantation for acute liver failure
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DOI：
10.1097/01.tp.0000276987.55382.e2
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发表时间：
2007-08-27
期刊：
影响因子：
6.2
通讯作者：
Batur, Yucel
中科院分区：
文献类型：
--
作者：
Kilic, Murat;Aydin, Unal;Batur, Yucel
背景急性肝功能衰竭（ALF）具有很高的死亡率，除非及时进行紧急原位肝移植（奥尔特）。活体供体首先用于治疗儿科病例，然后用于成人。在此，我们的目的是报告我们的经验与活体供者ALF在一个国家的死者供体器官捐献率只有1.5每百万人。在1999年6月至2005年12月进行的245例活体供肝移植（LDLT）中，其中14例（6%）为ALF，8例儿童和6例成人病例。成人病例采集右叶，而儿科病例采集左外侧段，但一名儿童移植了右叶移植物。病因：急性B型肝炎4例，甲型肝炎3例，肝豆状核变性2例，自身免疫性肝炎2例，不明原因3例。这些系列的三年移植物和患者存活率为79%。6例成人患者中有5例和8例儿童患者中有6例在移植后存活。没有任何供体死亡或主要发病率。LDLT为儿童和成人患者提供了一种安全有效的ALF治疗方式，以克服器官短缺的问题，特别是在从已故供体获得器官的机会很低的国家。
Background. Acute liver failure (ALF) carries a high mortality unless urgent orthotopic liver transplantation (OLT) is performed on time. Live donors are utilized to treat this irreversible condition first in pediatric cases and then in adults. Herein, we aimed to report our experience with live donors for ALF in a country of a deceased donor organ donation rate is only 1.5 per million people.Methods. Among the 245 live donor liver transplantations (LDLT) performed from June 1999 to December 2005, 14 of them (6%) were performed for ALF in 8 pediatric and 6 adult cases. Right lobes were harvested for the adult cases whereas left lateral segments were harvested for pediatric cases, except one child transplanted with a right lobe graft. The etiology of the disease was; acute hepatitis B in four cases, hepatitis A in three cases, Wilson disease two cases, autoimmune hepatitis in two cases, and was unknown in three cases.Results. Three-year graft and patient survival is 79% for these series. Five of the six adult patients and six of the eight pediatric cases survived after transplantation. There was not any donor mortality or major morbidity.Conclusions. LDLT offers a safe and effective modality of treatment for ALF for both pediatric and adult patients to overcome the problem of organ shortage especially in countries where the chance of receiving an organ from a deceased donor is low.