Living donor liver transplantation in adults.
Summary of "Living donor liver transplantation in adults."
The worldwide shortage of adequate donor organs implies that living donor liver transplantation represents a valuable alternative to cadaveric transplantation. In addition to the complex surgical procedure the correct identification of eligible donors and recipients plays a decisive role in living donor liver transplantation. Donor safety must be of ultimate priority and overrules all other aspects involved. In contrast to the slightly receding numbers in Europe and North America, in recent years Asian programs have enjoyed constantly increasing living donor activity. The experience of the past 15 years has clearly demonstrated that technical challenges of both bile duct anastomosis and venous outflow of the graft significantly influence postoperative outcome. While short-term in-hospital morbidity remains increased compared to cadaveric transplantation, long-term survival of both graft and patient are comparable or even better than in deceased donor transplantation. Especially for patients expecting long waiting times under the MELD allocation system, living donor liver transplantation offers an excellent therapeutic alternative. Expanding the so-called "Milan criteria" for HCC patients with the option for living donor liver transplantation is currently being controversially debated.
Affiliation
Klinik für Allgemein-, Visceral- und Transplantationschirurgie, Universitätsklinikum Aachen der Rheinland-Westfälischen Technischen Hochschule, Pauwelsstrasse 30, 52074, Aachen, Deutschland, uneumann@ukaachen.de.
Journal Details
This article was published in the following journal.
Name: Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen
ISSN: 1433-0385
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20676595
- DOI: http://dx.doi.org/10.1007/s00104-009-1874-x
Medical and Biotech [MESH] Definitions
Transplantation Chimera
An organism that, as a result of transplantation of donor tissue or cells, consists of two or more cell lines descended from at least two zygotes. This state may result in the induction of donor-specific TRANSPLANTATION TOLERANCE.
S-adenosylmethionine
Physiologic methyl radical donor involved in enzymatic transmethylation reactions and present in all living organisms. It possesses anti-inflammatory activity and has been used in treatment of chronic liver disease. (From Merck, 11th ed)
Radiation Chimera
An organism whose body contains cell populations of different genotypes as a result of the TRANSPLANTATION of donor cells after sufficient ionizing radiation to destroy the mature recipient's cells which would otherwise reject the donor cells.
End Stage Liver Disease
Final stage of a liver disease when the liver failure is irreversible and LIVER TRANSPLANTATION is needed.
Liver Transplantation
The transference of a part of or an entire liver from one human or animal to another.
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