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[Domino or sequential liver transplantation. Is it a feasible technique?]
J Figueras1, D Parés, M Munar-Qués
1Unidad de Trasplante Hepático. Ciutat Sanitaria i Universitaria de Bellvitge. L'Hospitalet de Llobregat. Barcelona. Spain. jfigueras@csub.scs.es
Gastroenterologia Y Hepatologia
|April 27, 2002
Summary
Domino liver transplantation (LT) is a viable technique where a donor liver from a patient with familial amyloidotic polyneuropathy (FAP) is transplanted into another patient. This method effectively increases graft availability with minimal risk to both recipients.
Area of Science:
- Hepatology
- Transplantation Surgery
- Nephrology
Context:
- Domino liver transplantation (LT) involves utilizing the explanted liver from a patient with familial amyloidotic polyneuropathy (FAP) for another recipient.
- This approach addresses organ shortages by increasing the availability of liver grafts.
Purpose:
- To evaluate the technical feasibility and outcomes of domino LT.
- To assess the safety and efficacy of using FAP explanted livers in non-FAP recipients.
Summary:
- Between 1999 and 2001, 10 domino LTs were performed alongside 121 cadaveric LTs.
- FAP patients (donors) had excellent outcomes, while second LT recipients showed varied results, including some mortality from recurrence and postoperative complications.
- No FAP recurrence was observed in the second LT recipients, indicating the safety of the domino procedure.
Impact:
- Domino LT is technically feasible and expands the donor pool.
- The procedure offers a solution to graft scarcity without significant risk to the FAP donor or the secondary recipient.