Emergency adult to adult living donor liver transplantation for fulminant hepatic failure

Citation
A. Marcos et al., Emergency adult to adult living donor liver transplantation for fulminant hepatic failure, TRANSPLANT, 69(10), 2000, pp. 2202-2205
Citations number
10
Categorie Soggetti
Medical Research Diagnosis & Treatment
Journal title
TRANSPLANTATION
ISSN journal
00411337 → ACNP
Volume
69
Issue
10
Year of publication
2000
Pages
2202 - 2205
Database
ISI
SICI code
0041-1337(20000527)69:10<2202:EATALD>2.0.ZU;2-F
Abstract
Background The high mortality rate associated with fulminant hepatic failur e combined with the Limited availability of cadaveric organs requires consi deration of alternatives to conventional cadaveric transplantation. Use of the donor right lobe in adult-to-adult living donor transplantation holds p romise in a variety of circumstances, including high-acuity situations. Methods. A 28-year-old male with fulminant hepatic failure secondary to hep atitis B was referred to our institution. He rapidly progressed to grade TV encephalopathy, and laboratory values were indicative of a poor prognosis without transplantation. He was listed for transplantation as UNOS status I . Three siblings were simultaneously evaluated for living liver donation. F ollowing established protocols, we completed donor evaluation in less than 24 hr, and donor right lobectomy and living donor transplantation were perf ormed within 36 hr of the recipient's admission to our center, Results. The donor surgery was uncomplicated, and the patient was discharge d on postoperative day 4. The recipient experienced full recovery and was d ischarged home on postoperative day 14, Of note, the first offer for a cada veric liver came more than 60 hr after Living donor transplantation. Conclusions, Thorough donor workup can be completed in less than 24 hr with out inappropriate abbreviation of the evaluation. Simultaneous workup of wi lling individuals prevents unnecessary delay. Living donor transplantation should be considered for patients with fulminant hepatic failure who are ap propriate transplant candidates.