Long-term results of living-related donor liver graft transplantation: A single-center analysis of 110 transplants

Background. Difficulties of cadaveric donation and serious donor shortage h ave led to the development and popularization of living-related donor liver graft transplantation (LRLT), Because the history of this procedure is rat her short, important aspects specific to this procedure have not been suffi ciently documented. The objective of this study was to analyze a single cen ter's 10-year experience with 110 LRLT in pediatric and adult patients with end-stage lives diseases. Methods, The medical records of 110 consecutive patients who underwent LRLT were reviewed. The recipients were comprised of 72 children and 38 adults. The graft volume corresponded to 26-192% of the recipient's standard liver volume. The relationship between pretransplant covariates and patient and graft survival was analyzed. Actuarial patient/graft survival rates were de termined at 1, 3, and 5 years. The type and incidence of posttransplant com plications were analyzed, as was long-term graft function. Results. The 1-, 3-, and 5-year actuarial patient and graft survival rates were 88%, 85%, and 85%, respectively. Log-rank test demonstrated that ABO-c ompatibility predicted patient survival rate, whereas patient age, underlyi ng disease, patient's clinical status, donor-recipient relation, donor age, and graft volume/ standard liver volume ratio did not. Long-term lives fun ction remains excellent. All the donors have re turned to normal daily live s with an uneventful course. Conclusions. LRLT is an efficacious procedure that provides excellent short -term and long-term survival. The indication criteria for both recipient an d donor were legitimate in this series, except for transplant across ABO-in compatibility, Cautious expansion of this procedure may be justified under the situation of serious shortage of cadaveric donor.