The progress of living donor liver transplantation at Cipto Mangunkusumo Hospital Jakarta Indonesia

Abstract

Liver transplantation nowadays has become the standard choice of practice for pediatric and adult patients with end-stage liver disease. We report our result for living donor liver transplantation (LDLT). Nine LDLT were performed on 6 paediatric and 3 adult cases starting at December 2010 was supported by colleagues from abroad (China, Singapore and Japan). The first adult LDLT was performed at our hospital. The indication of LT in pediatric cases were 4 biliary atresia and 2 autoimmune liver disease while 2 HCC with hepatitis B and one Kasai procedure survivor were the indication in adult. All the Donors were genetically related and there was one biliary leak which was treated by internal stent the rest are healthy and able to resume their routine after 2 weeks. There were no operative mortality in the paediatric patients while one adult patient died 32 days post operation due to aspiration induced by bile leaks sepsis. All the pediatric patients and the first adult patient survives until now with a good quality of life. The other one died after one year due to rejection. Prolong ascites and portal hypertension were the most common complications, both of which were successfully managed conservatively. All the pediatric cases received the left lateral liver lobe and the adult donors give their liver segment 5, 6, 7, 8 of with preservation of the middle hepatic vein. The adult graft to recipient ratio was 0.9%–1%. Conclusion: Availability of living donor and the tight schedule made the program progress run slowly.