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Lebendlebertransplantation

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Zusammenfassung

Die Lebertransplantation hat sich als unumstrittene Therapie von terminalen Lebererkrankungen etabliert. Bei zunehmendem Organmangel wurde 1988 erstmals eine Lebendlebertransplantation (Living donor liver transplantations LDLT) durchgeführt. Seither konnten viele, mit diesem Verfahren assoziierte, technische und sonstige Schwierigkeiten gelöst werden. In Kyoto können wir auf 14 erfolgreiche Jahre mit bereits über 900 Transplantationen seit Initiierung unseres Lebendlebertransplantationsprogramms, dem größten weltweit und ältesten in Japan, zurückblicken. Im Folgenden werden unsere Erfahrungen im Wandel der Zeit, unter besonderer Berücksichtigung von Sicherheit der Organspender, Ergebnissen nach Lebendlebertransplantation und potentiellen Komplikationen beim Empfänger, dargestellt. Ungelöste Probleme wie Größenmissverhältnis von Transplantat zu Empfänger, venöser Abstrom vom anterioren Segment eines transplantierten rechten Leberlappens, Lebendlebertransplantation bei Patienten mit hepatozellulärem Karzinom, AB0-Blutgruppen-inkompatible Lebendlebertransplantation und das Rezidiv einer HCV-Hepatitis werden thematisiert und Zukunftsperspektiven angezeigt.

Abstract

Liver transplantation has evolved into the standard treatment for numerous endstage liver diseases. The increase of organ shortages led to living organ donation. In 1988 living donor liver transplantation (LDLT) was performed for the first time. Since then multiple difficulties associated with LDLT have been solved. In Kyoto we can look back on more than 900 transplantations since the initiation of our LDLT program in 1990, which is the oldest in Japan and the largest in the world. In the following we review our extensive experience with special focus on issues such as donor safety, results after LDLT, and potential complications in the recipient. Further, graft size mismatching, venous drainage from anterior segment of the right lobe graft, LDLT for hepatocellular carcinoma, AB0-incompatible transplantation, and recurrence of hepatitis C infection, which are still unsolved problems in LDLT, are described and future directions are indicated.

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Authors and Affiliations

  1. Department of Transplantation and Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    K. Tanaka

  2. Transplant Unit, Kyoto University Hospital, Kyoto, Japan

    K. Tanaka & S. Kaihara

  3. Department of Transplantation and Immunology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, J-6068507 , Kyoto, Japan

    K. Tanaka

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  1. K. Tanaka
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  2. S. Kaihara
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Dieser Beitrag wurde übersetzt und bearbeitet von Dr. Peter Schemmer, Chirurgische Universitätsklinik Heidelberg

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Tanaka, K., Kaihara, S. Lebendlebertransplantation. Chirurg 74, 944–950 (2003). https://doi.org/10.1007/s00104-003-0744-1

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  • DOI: https://doi.org/10.1007/s00104-003-0744-1

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