Living-related Liver Transplantation: A Report 3 Cases

Objective:To review the clinical experience of 3 cases of living-related liver transplantation. Methods:The clinical course of 3 patients with congenital diffuse intrahepatic cholangiectasis, Wilson＇s disease and primary biliary cirrhosis respectively undergoing living-related liver transplantation was described in detail. Recent progress concerining liver transplantation was presented and discussed. Results:The donor liver was obtained from patients＇ fathers in 2 cases and from a healthy volunteer in 1 cases. The left hepatic lateral segments (260～300g) of the donors were used. All the donors recovered after operation. The recipients＇ operation lasted 11～13 hours with a blooding loss of 200～1500ml. For Case 1, a 10-year-old girl, post-transplantation intra-abdominal hemostasis was performed twice for bleeding from the resection surface of the liver and bolus steroid therapy was given for acute rejection on thd 11th day. Cyclosporin A is still being given for immunosuppression. Other complications including hydrothorax, ascites, and evisceration were all cured. She has survived 4 years with normal growth. Case 2, a 20-year-old female. Her blood type was O and the donor＇s was A. So her spleen was removed simultaneously. Immunosuppressive therapy consisted of cytoxan, FK506, MMF and adrenocortical hormones. Hepatic artery embolism and a hepatic vein embolism of segment Ⅲ occurred on day 15 after operation. An intraabdominal hemorrhage occured following thrombolytic therapy, the patient was re-operated upon on Day 17 survived 1 year in good health. Case 3, a 3-year-old boy, has survived 2 months with an uneventful recovery. Conclusions:The key-points for a successful living-related liver transplantation are strict indication, operation conducted while the patient is in good status and rational peri-operative management.