The safety of donors and recipients in infant living donor liver transplantation

Abstract

Objective To investigate the safety of donors and recipients in living donor liver transplantation (adults to infants). Methods From September 2006 to November 2009, 8 living donor liver transplantations were performed, and all of the recipients were diagnosed as having congenital biliary atresia. Triphasic liver computed tomography was used to display the shape of the liver and calculate total liver and liver lobes volumes in donors. Magnetic resonance cholangiopancreatography (MRCP) was used to examine the conditions of the bile tract. Suitable liver lobe was resected depending on the condition of recipients' abdomen. After the operation, all of the recipients received treatments including anti-rejection, anti-infection, etc. All the donors received liver protection and antisecretory treatments. The preoperative, intraoperative and postoperative states of donors and recipients were analyzed. Results All of the operations were performed successfully. For the grafts, 6 left lateral lobes, 1 hepatic S3 and 1 reduced-size hepatic S3 were obtained. The weight of lobe grafts was 148-302 g (235. 9 ± 53. 6 g). The ratio of graft weight to recipient weight ranged from 2. 11% to 3. 36 % (2. 65 % ± 0. 48 %). During a follow-up period of 3-40 months (median 18 months), there was no donor mortality, but 2 (25%) donors experienced complications. One (12. 5 %) of the 8 recipients died, and the remaining developed 13 cases/times of complications.Conclusion Accurate assessment of recipients and donors preoperatively, suitable resection of the grafts and precise operation intraoperatively, and careful treatment postoperatively can ensure safety of the recipients and donors to the maximum extent. Key words: Liver transplantation; Infant; Living donors; Safety