LIVING-RELATED LIVER-TRANSPLANTATION IN ADULTS

Objective To evaluate the outcome of living related liver transplantat ion (LRLT) in adult patients and to assess graft size disparity and gr aft regeneration. Summary Background Data Although LRLT has been accep ted as an optional life-saving procedure for pediatric patients with e nd-stage liver disease, the feasibility of LRLT for adult patients has not been reported with reference to a clinical series. Methods Adult- to-adult LRLT was performed using whole left lobar grafts in 13 patien ts (5 with primary biliary cirrhosis, 6 with familiar amyloid polyneur opathy, 1 with biliary atresia, and 1 with citrullinemia). The 13 dono rs comprised 5 husbands, 3 sons, 2 sisters, 2 fathers, and 1 mother. T he ratio of the graft volume to standard liver volume (GV/SV ratio) wa s calculated for use as a parameter of graft size disparity. Results A lthough the liver graft was markedly small for size (GV/SV ratio 32%-5 9% al the time of LRLT), none of the 13 patients developed postoperati ve liver failure. Eleven of the patients are still alive and well with satisfactory graft function 2 to 35 months after LRLT. Graft liver vo lume increased rapidly after LRLT and approximated the standard liver volume with time. Conclusions Our LRLT program for adult patients has produced good results. LRLT in adults can be indicated for selected do nor-recipient combinations.