Linked Life Data

14639495

Source:http://linkedlifedata.com/resource/pubmed/id/14639495

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
1
pubmed:dateCreated
2004-1-19
pubmed:abstractText
Living donor liver transplantation (LDLT) has developed on the basis of increased safety of conventional liver surgery and the need for expanding donor sources, especially in children. Indications for LDLT were soon extended to adult patients in Japan, where cadaveric donation was limited. The right liver is now routinely transplanted to adults to avoid small-for-size graft syndrome, even though the right liver graft has the disadvantages of less remaining donor liver and the question of donor safety. Assessing the suitable size or quality of the graft, as well as of the remnant donor liver, is one of the most important problems in adult LDLT. Although several tactics have been proposed to manage the small-for-size syndrome, their efficacy remains a question. We suggest that small-for-size syndrome is preventable by engaging in careful donor selection or using effective agents for hepatic microcirculatory disturbance control. Sometimes for LDLT only ABO-incompatible grafts are available from relatives, but they must be transplanted despite the expected poor outcome in adults and older children. To overcome the problems in this situation, we developed a novel protocol including intraportal infusion therapy with methylprednisolone, prostaglandin E1, and gabexate mesylate. Two adult patients undergoing ABO-incompatible LDLT have now survived 53 and 35 months after transplantation with good liver function. However, the other two patients suffered thrombotic microangiopathy postoperatively and died owing to cerebral hemorrhage or multiple organ failure, respectively. Further investigation is needed to improve the outcome of liver transplantation across the ABO blood group barrier.
pubmed:commentsCorrections
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jan
pubmed:issn
0364-2313
pubmed:author
pubmed:issnType
Print
pubmed:volume
28
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
2-7
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed:year
2004
pubmed:articleTitle
Living donor liver transplantation with special reference to ABO-incompatible grafts and small-for-size grafts.
pubmed:affiliation
Department of Surgery, Keio University School of Medicine, Tokyo, Japan. shimazu@sc.itc.keio.ac.jp
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't