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Adult-to-adult right-lobe living donor liver transplantation in high model for end-stage liver disease score recipients with hepatitis B virus-related benign liver diseases

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Abstract

Purpose

We evaluated the safety and efficacy of adult-to-adult right-lobe living donor liver transplantation (ARL-LDLT) in HBV-related benign liver disease recipients with high model for end-stage liver disease (MELD) scores.

Methods

The subjects of this study were 70 adult patients who underwent ARL-LDLT and 191 who underwent DDLT, for HBV-related end-stage liver diseases, between May 2002 and December 2009. Short-term outcomes were assessed by 30-day mortality and graft loss, parameters indicating graft dysfunction, length of hospital stay, and postoperative complications within 3 months. Long-term transplant outcomes were measured by graft- and patient survival and HBV recurrence rates at 1, 3, and 5 years.

Results

There were no differences in donor outcomes or recipient short-term outcomes between the groups, although recipients with a high MELD score (Group H) had a higher incidence of pneumonia. High MELD score versus low MELD score recipients had similar 1-, 3-, and 5-year patient survival rates and post-transplant HBV recurrence rates. In the matched DDLT cases, a similar tendency was observed between group H and group L.

Conclusions

ARL-LDLT can be performed safely and effectively in high-MELD score patients with HBV-related benign liver disease; thus, a high MELD score may not contraindicate ARL-LDLT.

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References

  1. Kam I. Adult-adult right hepatic lobe living donor liver transplantation for status 2a patients: too little, too late. Liver Transpl. 2002;8:347–9.

    Article  PubMed  Google Scholar 

  2. Testa G, Malagó M, Nadalin S, Hertl M, Lang H, Frilling A, et al. Right-liver living donor transplantation for decompensated end-stage liver disease. Liver Transpl. 2002;8:340–6.

    Article  PubMed  Google Scholar 

  3. Selzner M, Kashfi A, Cattral MS, Selzner N, McGilvray ID, Greig PD, et al. Live donor liver transplantation in high MELD score recipients. Ann Surg. 2010;251:153–7.

    Article  PubMed  Google Scholar 

  4. Fisher RA, Kulik LM, Freise CE, Lok AS, Shearon TH, Brown RS Jr, et al. Hepatocellular carcinoma recurrence and death following living and deceased donor liver transplantation. Am J Transplant. 2007;7:1601–8.

    Article  PubMed  CAS  Google Scholar 

  5. Jiang L, Yan L, Li B, Wen T, Zhao J, Jiang L, et al. Successful use of hepatitis B surface antigen-positive liver grafts in recipients with hepatitis B virus-related liver diseases. Liver Transpl. 2011;17:1236–8.

    Article  PubMed  Google Scholar 

  6. Jiang L, Yan L, Li B, Wen T, Zhao J, Jiang L, et al. Prophylaxis against hepatitis B recurrence posttransplantation using lamivudine and individualized low-dose hepatitis B immunoglobulin. Am J Transplant. 2010;10:1861–9.

    Article  PubMed  CAS  Google Scholar 

  7. Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, et al. The Clavien–Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250:187–96.

    Article  PubMed  Google Scholar 

  8. Fujiwara K, Mochida S, Matsui A, Nakayama N, Nagoshi S, Toda G. Fulminant hepatitis and late onset hepatic failure in Japan. Hepatol Res. 2008;38:646–57.

    Article  PubMed  Google Scholar 

  9. Yi NJ, Suh KS, Lee HW, Shin WY, Kim J, Kim W, et al. Improved outcome of adult recipients with a high model for end-stage liver disease score and a small-for-size graft. Liver Transpl. 2009;15:496–503.

    Article  PubMed  Google Scholar 

  10. Ghobrial RM, Freise CE, Trotter JF, Tong L, Ojo AO, Fair JH, et al. Donor morbidity after living donation for liver transplantation. Gastroenterology. 2008;135:468–76.

    Article  PubMed  Google Scholar 

  11. Lo CM. Complications and long-term outcome of living liver donors: a survey of 1,508 cases in five Asian centers. Transplantation. 2003;75:S12–5.

    Article  PubMed  Google Scholar 

  12. Umeshita K, Fujiwara K, Kiyosawa K, Makuuchi M, Satomi S, Sugimachi K, et al. Operative morbidity of living liver donors in Japan. Lancet. 2003;362:687–90.

    Article  PubMed  Google Scholar 

  13. Akyildiz M, Karasu Z, Arikan C, Kilic M, Zeytunlu M, Gunsar F, et al. Impact of pretransplant MELD score on posttransplant outcome in living donor liver transplantation. Transplant Proc. 2004;36:1442–4.

    Article  PubMed  CAS  Google Scholar 

  14. Freise CE, Gillespie BW, Koffron AJ, Lok AS, Pruett TL, Emond JC, et al. Recipient morbidity after living and deceased donor liver transplantation: findings from the A2ALL Retrospective Cohort Study. Am J Transplant. 2008;8:2569–79.

    Article  PubMed  CAS  Google Scholar 

  15. Olthoff KM, Merion RM, Ghobrial RM, Abecassis MM, Fair JH, Fisher RA, et al. Outcomes of 385 adult-to-adult living donor liver transplant recipients: a report from the A2ALL Consortium. Ann Surg. 2005;242:314–23.

    PubMed  Google Scholar 

  16. Roche B, Samuel D. Evolving strategies to prevent HBV recurrence. Liver Transpl. 2004;10:S74–85.

    Article  PubMed  Google Scholar 

  17. Kubo S, Tanaka H, Shuto T, Takemura S, Yamamoto T, Kanazawa A, et al. Clinicopathologic features and outcome after liver resection for hepatocellular carcinoma in patients with concurrent versus previous chronic hepatitis B. Surg Today. 2005;35:216–22.

    Article  PubMed  Google Scholar 

  18. Markowitz JS, Martin P, Conrad AJ, Markmann JF, Seu P, Yersiz H, et al. Prophylaxis against hepatitis B recurrence following liver transplantation using combination lamivudine and hepatitis B immune globulin. Hepatology. 1998;28:585–9.

    Article  PubMed  CAS  Google Scholar 

  19. Steinmüller T, Seehofer D, Rayes N, Müller AR, Settmacher U, Jonas S, et al. Increasing applicability of liver transplantation for patients with hepatitis B-related liver disease. Hepatology. 2002;35:1528–35.

    Article  PubMed  Google Scholar 

  20. Marzano A, Salizzoni M, Debernardi-Venon W, Smedile A, Franchello A, Ciancio A, et al. Prevention of hepatitis B virus recurrence after liver transplantation in cirrhotic patients treated with lamivudine and passive immunoprophylaxis. J Hepatol. 2001;34:903–10.

    Article  PubMed  CAS  Google Scholar 

  21. Gane EJ, Angus PW, Strasser S, Crawford DH, Ring J, Jeffrey GP, et al. Lamivudine plus low-dose hepatitis B immunoglobulin to prevent recurrent hepatitis B following liver transplantation. Gastroenterology. 2007;132:931–7.

    Article  PubMed  CAS  Google Scholar 

  22. Zheng S, Chen Y, Liang T, Lu A, Wang W, Shen Y, et al. Prevention of hepatitis B recurrence after liver transplantation using lamivudine or lamivudine combined with hepatitis B Immunoglobulin prophylaxis. Liver Transpl. 2006;12:253–8.

    Article  PubMed  Google Scholar 

  23. Lok AS, Heathcote EJ, Hoofnagle JH. Management of hepatitis B: 2000—summary of a workshop. Gastroenterology. 2001;120:1828–53.

    Article  PubMed  CAS  Google Scholar 

  24. Seehofer D, Rayes N, Berg T, Neuhaus R, Müller AR, Hopf U, et al. Lamivudine as first- and second-line treatment of hepatitis B infection after liver transplantation. Transpl Int. 2000;13:290–6.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

This research was supported by a grant from the National Natural Science Foundation of China (81170456).

Conflict of interest

L. Yan and co-authors have no conflicts of interest to declare.

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Correspondence to Lunan Yan.

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Jiang, L., Yan, L., Tan, Y. et al. Adult-to-adult right-lobe living donor liver transplantation in high model for end-stage liver disease score recipients with hepatitis B virus-related benign liver diseases. Surg Today 43, 1039–1048 (2013). https://doi.org/10.1007/s00595-013-0539-z

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  • DOI: https://doi.org/10.1007/s00595-013-0539-z

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