LIVING-RELATED DONOR LIVER-TRANSPLANTATION

Living related liver transplantation (LRLT) has been developed in resp onse to the paediatric organ donor shortage. According to the Internat ional Living Donor Registry, 521 transplants had been performed in 515 patients between December 8 1988 and January 19 1996 in 30 centres wo rldwide. The overall actuarial patient and graft survival rates were 8 2.7 and 80%, respectively. Between June 17 1994 and November 30 1996, the authors performed 11 LRLT at the Chung Gung Memorial Hospital, The living donors consisted of 10 mothers and one father. The mean graft weight was 303 g and the mean graft recipient weight ratio was 2.2%. D onor hepatectomy was performed without vascular inflow occlusion. The intra-operative blood loss ranged from 30 mL to 120 mL with an average of 61 mL, and blood transfusion was not required in all donors both i ntra-operatively and during the postoperative period. Underlying disea ses of the recipients were biliary atresia (n = 10) and glycogen stora ge disease (n = 1). The mean graft cold ischaemia time was 106 min, th e mean second warm ischaemia time was 51 min and the mean interval bet ween portal and arterial reperfusion was 81 min. The initial LRLT resu lts were promising with all donors having been discharged without comp lication. The recipients experienced a few complications, all of which were manageable with early intervention. All 11 recipients are alive and well, These are encouraging results and the authors hope to expand the use of live donors for liver transplantation to cope with demand.