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Living-related liver transplantation for primary biliary cirrhosis
Y Sugawara1, M Makuuchi, T Takayama
1Department of Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Background:
The prognosis of patients with primary biliary cirrhosis has improved since the introduction of transplantation. However, there has been limited experience with living-related liver transplantation for primary biliary cirrhosis.
Patients And Methods:
Between January 1996 and October 2000, 105 patients underwent living-related liver transplantation at the University of Tokyo Hospital. Eighteen of these patients with primary biliary cirrhosis were the subjects of this study. The risk scores in the conventional and updated Mayo models ranged from 5.9 to 11.6 and 6.9 to 13.7, respectively.
Results:
The graft weight ranged from 330 to 533 g, corresponding to 33 to 55% of the recipient's standard liver volume. Two patients died of pneumonia, 1 died due to sepsis, and the remaining 15 patients survived. The risk scores for the conventional and updated Mayo models correlated well with the duration of hospitalization (P=0.01, R=0.67 for both). The scores of the dead patients by the two models were more than 10 and 12, respectively. The postoperative courses of all of the donors were uneventful.
Conclusions:
The risk score in the Mayo model adequately reflected the outcome of the patients. To achieve the best possible outcome, further therapeutic tactics are necessary for patients with conventional or updated Mayo risk scores of more than 10 or 12, respectively.