OBJECTIVES: Living donor liver transplantation (LDLT) is an accepted treatment for patients with end-stage liver disease. To minimize risk to the donor, left lobe (LL) LDLT may be an ideal option in adult LDLT. METHODS: This study assessed the outcomes of LL-LDLT compared with right lobe (RL) LDLT in adults (1998-2010) as reported to the United Network for Organ Sharing (UNOS) Organ Procurement and Transplantation Network (OPTN). RESULTS: A total of 2844 recipients of LDLT were identified. Of these, 2690 (94.6%) underwent RL-LDLT and 154 (5.4%) underwent LL-LDLT. A recent increase in the number of LL-LDLTs was noted: average numbers of LL-LDLTs per year were 5.2 during 1998-2003 and 19.4 during 2004-2010. Compared with RL-LDLT recipients, LL-LDLT recipients were younger (mean age: 50.5 years vs. 47.0 years), had a lower body mass index (BMI) (mean BMI: 24.5 kg/m(2) vs. 26.8 kg/m(2)), and were more likely to be female (64.6% vs. 41.9%). Donors in LL-LDLT had a higher BMI (mean BMI: 29.4 kg/m(2) vs. 26.5 kg/m(2)) and were less likely to be female (30.9% vs. 48.1%). Recipients of LL-LDLT had a longer mean length of stay (24.9 days vs. 18.2 days) and higher retransplantation rates (20.3% vs. 10.9%). Allograft survival in LL-LDLT was significantly lower than in RL-LDLT and there was a trend towards inferior patient survival. In Cox regression analysis, LL-LDLT was found to be associated with an increased risk for allograft failure [hazard ratio (HR): 2.39)] and inferior patient survival (HR: 1.86). CONCLUSIONS: The number of LL-LDLTs has increased in recent years.
OBJECTIVES: Living donor liver transplantation (LDLT) is an accepted treatment for patients with end-stage liver disease. To minimize risk to the donor, left lobe (LL) LDLT may be an ideal option in adult LDLT. METHODS: This study assessed the outcomes of LL-LDLT compared with right lobe (RL) LDLT in adults (1998-2010) as reported to the United Network for Organ Sharing (UNOS) Organ Procurement and Transplantation Network (OPTN). RESULTS: A total of 2844 recipients of LDLT were identified. Of these, 2690 (94.6%) underwent RL-LDLT and 154 (5.4%) underwent LL-LDLT. A recent increase in the number of LL-LDLTs was noted: average numbers of LL-LDLTs per year were 5.2 during 1998-2003 and 19.4 during 2004-2010. Compared with RL-LDLT recipients, LL-LDLT recipients were younger (mean age: 50.5 years vs. 47.0 years), had a lower body mass index (BMI) (mean BMI: 24.5 kg/m(2) vs. 26.8 kg/m(2)), and were more likely to be female (64.6% vs. 41.9%). Donors in LL-LDLT had a higher BMI (mean BMI: 29.4 kg/m(2) vs. 26.5 kg/m(2)) and were less likely to be female (30.9% vs. 48.1%). Recipients of LL-LDLT had a longer mean length of stay (24.9 days vs. 18.2 days) and higher retransplantation rates (20.3% vs. 10.9%). Allograft survival in LL-LDLT was significantly lower than in RL-LDLT and there was a trend towards inferior patient survival. In Cox regression analysis, LL-LDLT was found to be associated with an increased risk for allograft failure [hazard ratio (HR): 2.39)] and inferior patient survival (HR: 1.86). CONCLUSIONS: The number of LL-LDLTs has increased in recent years.
Authors: Mark L Barr; Jacques Belghiti; Federico G Villamil; Elizabeth A Pomfret; David S Sutherland; Rainer W Gruessner; Alan N Langnas; Francis L Delmonico Journal: Transplantation Date: 2006-05-27 Impact factor: 4.939
Authors: S Kawasaki; M Makuuchi; H Matsunami; Y Hashikura; T Ikegami; Y Nakazawa; H Chisuwa; M Terada; S Miyagawa Journal: Ann Surg Date: 1998-02 Impact factor: 12.969
Authors: Y Soejima; A Taketomi; T Yoshizumi; H Uchiyama; N Harada; H Ijichi; Y Yonemura; M Shimada; Y Maehara Journal: Am J Transplant Date: 2006-05 Impact factor: 8.086
Authors: M E Wachs; T E Bak; F M Karrer; G T Everson; R Shrestha; T E Trouillot; M S Mandell; T G Steinberg; I Kam Journal: Transplantation Date: 1998-11-27 Impact factor: 4.939
Authors: Christina Hackl; Hans J Schlitt; Gabriele I Kirchner; Birgit Knoppke; Martin Loss Journal: World J Gastroenterol Date: 2014-05-14 Impact factor: 5.742