Related Experiment Videos
Living related liver transplantation
1Department of Transplantation and Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan. takaday@kuhp.kyoto-u.ac.jp
Transplantation Proceedings
|March 26, 2004
Summary
Living related liver transplantation (LRLT) addresses donor organ shortages. Cyclosporine
Area of Science:
- Hepatology and Transplant Surgery
- Immunosuppression Therapy
Background:
- Cyclosporine revolutionized liver transplantation, increasing procedures but creating organ shortages.
- Living related liver transplantation (LRLT) emerged to mitigate waiting list mortality.
- Kyoto University's LRLT program, initiated in 1990, expanded from pediatric to adult recipients.
Purpose of the Study:
- To evaluate the evolving role of cyclosporine in living related liver transplantation.
- To assess immunosuppressive strategies in LRLT, particularly the impact of Neoral versus Sandimmun.
Main Methods:
- Retrospective analysis of LRLT cases at Kyoto University since 1990.
- Review of immunosuppressive regimens, focusing on tacrolimus, steroids, and cyclosporine formulations.
- Evaluation of clinical efficacy data comparing different cyclosporine-based immunosuppression protocols.
Main Results:
- The introduction of right lobe grafts became standard for adult-to-adult LRLT.
- Initial immunosuppression involved tacrolimus and low-dose steroids.
- Neoral demonstrated improved clinical efficacy over Sandimmun, prompting reevaluation of cyclosporine's role.
Conclusions:
- Living related liver transplantation, including adult-to-adult right lobe grafts, is a viable strategy.
- The efficacy of Neoral necessitates a reevaluation of cyclosporine's place in LRLT immunosuppression.
- Optimizing immunosuppression remains crucial for successful LRLT outcomes.