[Adult-to-adult living donor liver transplantation for decompensated end-stage liver diseases].

Objective To summarize our clinical experience in adult-to-adult living donor liver transplantation (ALDLT). Methods Clinical data of 12 patients with ALDLT performed in our center from September 2000 to June 2005 were analyzed, retrospectively. Results Left lobe (segments Ⅱ, Ⅲ, Ⅳ, including the middle hepatic veins) transplantation was performed in 3 patients and right lobe (segments Ⅴ, Ⅵ, Ⅶ,Ⅷ, with or without the middle hepatic veins) transplantation was performed in 9 patients. Donors: There were no operative deaths. The median operative time was 6.20 ± 1.40 hours and their blood loss ranged from 300 ml to 1 200 ml. Postoperative complications included biliary fistula (1 donor) and wound fat liquefaction (1 donor). During a 6-12 months follow-up, no long-term complications were found. Recipients: The operating time ranged from 5 to 11 hours and their blood loss ranged from 800 to 7 000 ml. Modified outflow reconstruction, microvascular reconstruction of the hepatic artery and duct-to-duct biliary reconstruction were done during the recipient operations. The median cold ischemia time was 1.90 ± 0.50 hours. The median anhepatic phase of recipients was 1.63 ± 0.43 hours. Graft/recipient weight ratio (GRWR) was (1.20 ± 0.26) %. One recipient presented a postoperative complication of biliary fistula and another recipient died 1 month after the operation from serious infection. The other 11 recipients had long-term survivals. Conclusion ALDLT is an effective treatment for decompansated end-stage liver disease patients and is relatively safe for the donors.