| Portal pressure <15 mm Hg is a key for successful adult living donor liver transplantation utilizing smaller grafts than before. | |
| | |
MedLine Citation:
|
PMID: 20517905 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
To prevent small-for-size syndrome in adult-to-adult living donor liver transplantation (A-LDLT), larger grafts (ie, right lobe grafts) have been selected in many transplant centers. However, some centers are investigating the benefits of portal pressure modulation. Five hundred sixty-six A-LDLT procedures using right or left lobe grafts were performed between 1998 and 2008. In 2006, we introduced intentional portal pressure control, and we changed the graft selection criteria to include a graft/recipient weight ratio >0.7% instead of the original value of >0.8%. All recipients were divided into period I (1998-2006, the era of unintentional portal pressure control; n = 432) and period II (2006-2008, the era of intentional portal pressure control; n = 134). The selection of small-for-size grafts increased from 7.8% to 23.9%, and the selection of left lobe grafts increased from 4.9% to 32.1%. Despite the increase in the number of smaller grafts in period II, 1-year patient survival was significantly improved (87.9% versus 76.2%). In 129 recipients in period II, portal pressure was monitored. Patients with a portal pressure <15 mm Hg demonstrated better 2-year survival (n = 86, 93.0%) than patients with a portal pressure >or=15 mm Hg (n = 43, 66.3%). The recovery from hyperbilirubinemia and coagulopathy after transplantation was significantly better in patients with a portal pressure <15 mm Hg. In conclusion, our strategy for A-LDLT has changed from larger graft-based A-LDLT to controlled portal pressure-based A-LDLT with smaller grafts. A portal pressure <15 mm Hg seems to be a key for successful A-LDLT. |
| | |
Authors:
|
Yasuhiro Ogura; Tomohide Hori; Walid M El Moghazy; Atsushi Yoshizawa; Fumitaka Oike; Akira Mori; Toshimi Kaido; Yasutsugu Takada; Shinji Uemoto |
Related Documents
:
|
7240435 - Drug interaction: meperidine and chlorpromazine, a toxic combination. 11211905 - Overexpression of endothelin-1 in bile duct ligated rats: correlation with activation o... 2718255 - Differential diagnosis of ascitic fluid: evaluation and comparison of various biochemic... 19418395 - Computerized endoscopic balloon manometry to detect esophageal variceal pressure. 3555355 - Improved pressure sore healing with hydrocolloid dressings. 12719445 - Heritability of blood pressure and hemodynamics in african- and european-american youth. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society Volume: 16 ISSN: 1527-6473 ISO Abbreviation: Liver Transpl. Publication Date: 2010 Jun |
Date Detail:
|
Created Date: 2010-06-02 Completed Date: 2010-09-14 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 100909185 Medline TA: Liver Transpl Country: United States |
Other Details:
|
Languages: eng Pagination: 718-28 Citation Subset: IM |
Copyright Information:
|
(c) 2010 AASLD. |
Affiliation:
|
Division of Hepatobiliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. oguchan@kuhp.kyoto-u.ac.jp |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Ascites / etiology Blood Coagulation Disorders / etiology Body Weight Female Humans Hyperbilirubinemia / etiology Japan Kaplan-Meiers Estimate Liver / anatomy & histology, blood supply, surgery* Liver Transplantation* / adverse effects, mortality Living Donors / supply & distribution* Male Middle Aged Patient Selection Portal Pressure* Portasystemic Shunt, Surgical Proportional Hazards Models Prothrombin Time Retrospective Studies Risk Assessment Risk Factors Splenectomy Time Factors Treatment Outcome |
| Comments/Corrections | |
Comment In:
|
Liver Transpl. 2010 Jun;16(6):695-6
[PMID:
20517901
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: T-Tube or no T-tube in the reconstruction of the biliary tract during orthotopic liver transplantati...
Next Document: Contrast-enhanced ultrasound for the evaluation of hepatic artery stenosis after liver transplantati...