Tags

Type your tag names separated by a space and hit enter

A decade of right liver adult-to-adult living donor liver transplantation: the recipient mid-term outcomes.
Ann Surg. 2008 Sep; 248(3):411-9.AnnS

Abstract

OBJECTIVE

We analyzed a single center's experience over a decade of right liver living donor liver transplantation (RLDLT).

SUMMARY BACKGROUND DATA

To define the donor risk and recipient benefit ratio, midterm outcome of this life-saving treatment modality ought to be known.

METHODS

Consecutive patients from 9 May 1996 were included. Era I comprised the first 50 patients and Era II comprised the remaining 184 patients. Their midterm outcomes were compared with patients receiving deceased donor liver transplantation (DDLT) of the same period in the same center.

RESULTS

With a median follow-up of 48 months, the 1-, 3-, and 5-year overall survival rates were 93.2%, 85.7%, and 82.4%, respectively and were comparable with those of DDLT (n = 131) (90.1%, 87.7%, and 85.2%) (P = 0.876). Hospital mortality decreased from 16% in Era I to 2.2% in Era II (P = 0.000). Reduced hospital mortality improved the overall survival rates from Era I to Era II (78%, 74%, and 72% vs. 97.3%, 88.7%, and 85.1%, respectively) (P = 0.003). The 5-year survival rate of recipients with hepatocellular carcinoma (HCC) (n = 65) was 65.7%. Starting from Era II, excellent 5-year survival of recipients without HCC was achieved as compared with DDLT in the same period (93.4% vs. 88.2%) (P = 0.493). The 5-year survival rates of recipients with HCC within the Milan criteria of Era II and DDLT in the same period were 72.0% and 100%, respectively (P = 0.091). Multivariate analysis indicated that only Era I (relative risk = 2.606; P = 0.005) and pretransplant HCC (relative risk = 2.729; P = 0.002) adversely affected overall survival.

CONCLUSIONS

High midterm survivals were achieved by reduction of hospital mortality through accumulation of experience and transplanting recipients with low chance of recurrence of HCC. RLDLT could be considered as a legitimate alternative to DDLT.

Authors+Show Affiliations

Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18791361

Citation

Chan, See Ching, et al. "A Decade of Right Liver Adult-to-adult Living Donor Liver Transplantation: the Recipient Mid-term Outcomes." Annals of Surgery, vol. 248, no. 3, 2008, pp. 411-9.
Chan SC, Fan ST, Lo CM, et al. A decade of right liver adult-to-adult living donor liver transplantation: the recipient mid-term outcomes. Ann Surg. 2008;248(3):411-9.
Chan, S. C., Fan, S. T., Lo, C. M., Liu, C. L., Wei, W. I., Chik, B. H., & Wong, J. (2008). A decade of right liver adult-to-adult living donor liver transplantation: the recipient mid-term outcomes. Annals of Surgery, 248(3), 411-9. https://doi.org/10.1097/SLA.0b013e31818584e6
Chan SC, et al. A Decade of Right Liver Adult-to-adult Living Donor Liver Transplantation: the Recipient Mid-term Outcomes. Ann Surg. 2008;248(3):411-9. PubMed PMID: 18791361.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A decade of right liver adult-to-adult living donor liver transplantation: the recipient mid-term outcomes. AU - Chan,See Ching, AU - Fan,Sheung Tat, AU - Lo,Chung Mau, AU - Liu,Chi Leung, AU - Wei,William I, AU - Chik,Barbara Hsia-Ying, AU - Wong,John, PY - 2008/9/16/pubmed PY - 2008/9/27/medline PY - 2008/9/16/entrez SP - 411 EP - 9 JF - Annals of surgery JO - Ann Surg VL - 248 IS - 3 N2 - OBJECTIVE: We analyzed a single center's experience over a decade of right liver living donor liver transplantation (RLDLT). SUMMARY BACKGROUND DATA: To define the donor risk and recipient benefit ratio, midterm outcome of this life-saving treatment modality ought to be known. METHODS: Consecutive patients from 9 May 1996 were included. Era I comprised the first 50 patients and Era II comprised the remaining 184 patients. Their midterm outcomes were compared with patients receiving deceased donor liver transplantation (DDLT) of the same period in the same center. RESULTS: With a median follow-up of 48 months, the 1-, 3-, and 5-year overall survival rates were 93.2%, 85.7%, and 82.4%, respectively and were comparable with those of DDLT (n = 131) (90.1%, 87.7%, and 85.2%) (P = 0.876). Hospital mortality decreased from 16% in Era I to 2.2% in Era II (P = 0.000). Reduced hospital mortality improved the overall survival rates from Era I to Era II (78%, 74%, and 72% vs. 97.3%, 88.7%, and 85.1%, respectively) (P = 0.003). The 5-year survival rate of recipients with hepatocellular carcinoma (HCC) (n = 65) was 65.7%. Starting from Era II, excellent 5-year survival of recipients without HCC was achieved as compared with DDLT in the same period (93.4% vs. 88.2%) (P = 0.493). The 5-year survival rates of recipients with HCC within the Milan criteria of Era II and DDLT in the same period were 72.0% and 100%, respectively (P = 0.091). Multivariate analysis indicated that only Era I (relative risk = 2.606; P = 0.005) and pretransplant HCC (relative risk = 2.729; P = 0.002) adversely affected overall survival. CONCLUSIONS: High midterm survivals were achieved by reduction of hospital mortality through accumulation of experience and transplanting recipients with low chance of recurrence of HCC. RLDLT could be considered as a legitimate alternative to DDLT. SN - 1528-1140 UR - https://www.unboundmedicine.com/medline/citation/18791361/A_decade_of_right_liver_adult_to_adult_living_donor_liver_transplantation:_the_recipient_mid_term_outcomes_ L2 - https://Insights.ovid.com/pubmed?pmid=18791361 DB - PRIME DP - Unbound Medicine ER -