LIVING-RELATED PARTIAL LIVER-TRANSPLANTATION IN BILIARY ATRESIA - 11 CASES OF EXPERIENCE

Eleven children, 4 males and 7 females, with biliary atresia receiving living related liver graft were studied. The mean age was 1.8 years a nd the mean body weight was 10.3 kg. The donors were 4 fathers and 7 m others. The graft was the lateral segment or left lobe. ABO blood grou p matching was compatible in 9 and incompatible in 2. All patients exc ept one were crossmatch negative. Immunosuppression at induction was t riple therapy (cyclosporine, azathioprine and steroid) or FK506 plus s teroid. Acute rejection episodes were treated with pulse steroids. Whe n the signs of rejection persisted despite steroid pulse therapy, 15-d eozyspergualin (DSG) was added. The survival rate of the patients was 73%. Three patients died of portal vein thrombosis, hepatic artery thr ombosis and sepsis respectively. Other major complications included hy perbilirubinemia, bile duct stenosis, bile leakage and portal vein ana stomosis narrowing. Complications of the donor were sepsis in one, and liver dysfunction in two. Although there are some complications relat ed to graft size mismatch and operative procedure, living related part ial liver transplantation is an effective therapy in countries where d onor source is restricted.