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Live-donor liver transplantation: the USC experience
1Department of Surgery, Children's Hospital, Los Angeles, California, USA.
Acta Chirurgica Belgica
|January 5, 2002
Summary
Live donor liver transplantation (LDLT) shows excellent results in children but carries a significant complication rate in adults. This study analyzes initial LDLT experiences at USC, highlighting its potential and challenges.
Area of Science:
- Hepatology
- Transplantation Surgery
- Pediatric Surgery
Background:
- Liver transplantation is the standard treatment for end-stage liver disease.
- Cadaveric organ shortage necessitates alternative strategies like live donor liver transplantation (LDLT).
- This study presents initial LDLT experiences at USC.
Purpose of the Study:
- To analyze the initial outcomes of live donor liver transplantation (LDLT) at USC.
- To evaluate the efficacy and safety of LDLT in pediatric and adult populations.
- To compare LDLT results with cadaveric transplantation.
Main Methods:
- A retrospective analysis of 27 LDLT procedures performed between September 1998 and July 2000.
- Inclusion of 12 pediatric patients (median age 10 months) and 15 adult patients (median age 56 years).
- Common indications: biliary atresia in children and hepatitis C in adults.
Main Results:
- All donors had favorable postoperative outcomes with short hospital stays and no major complications.
- Pediatric recipients achieved a 100% survival rate with one graft loss due to rejection.
- Adult recipients experienced higher complication rates (37%), including biliary reconstruction issues, and mortality (2/15).
Conclusions:
- LDLT is a viable alternative to cadaveric transplantation, demonstrating excellent outcomes in pediatric patients.
- LDLT in adult patients is associated with a significant complication rate and requires cautious application.
- Further research is needed to optimize LDLT protocols for adult recipients.
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