Factors affecting graft survival after living donor liver transplantation

Lee, D. S.; Gil, Won Ho; Lee, H. H.; Lee, Kwang‐Woong; Lee, S. K.; Kim, S. J.; Choi, Seong Ho; Heo, Jin Seok; Hyon, Won-Sok; Kim, G. S.; Paik, Seung Woon; Koh, Kwang Cheol; Joh, Jae‐Won

doi:10.1016/j.transproceed.2004.08.073

Cited by 48 publications

(30 citation statements)

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“…But why and how the age of the donor affects the outcome of LDLT remains unclear because LDLT has very short CIT (33,34). In the retrospective study, the aged donor group had a significantly poorer prognosis, the same as with deceased donor liver transplantation, as compared with that of the younger donor group.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Donor Age on the Outcome of Adult Living Donor Liver Transplantation

et al. 2008

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Section: Discussionmentioning

confidence: 99%

The Impact of Donor Age on the Outcome of Adult Living Donor Liver Transplantation

et al. 2008

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“…The graft/body weight ratio was only 0.68%, less than the recommended minimum of 0.8%. [27][28][29] Viral Load Increased More Rapidly in LDLT Patients and Was Higher During the First Two Weeks After Surgery. After the initial decline, HCV RNA levels were higher in the LDLT group at all post-LT time points (Table 3).…”

Section: Early Viral Kineticsmentioning

confidence: 97%

Accelerated hepatitis C virus kinetics but similar survival rates in recipients of liver grafts from living versus deceased donors†‡

et al. 2005

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This study tested the hypothesis that hepatitis C virus (HCV) RNA and core antigen levels rise more rapidly after liver transplantation (LT) in recipients of grafts from living donors (LD) versus deceased donors (DD). Eleven consecutive LD and 15 DD recipients were followed prospectively. Before LT, median HCV RNA levels were similar: 5.42 (LDLT) and 5.07 (DDLT) log 10 IU/mL (P ‫؍‬ NS). During the first 7 hours after LT a trend toward a greater HCV RNA decrease in LDLT patients was seen, although they received fewer blood replacement products during surgery. HCV RNA levels rose more rapidly in LDLT patients between days 1 and 3 (P ‫؍‬ .0059) and were higher in this group on days 2, 3, 4, and 5. Core antigen levels were significantly higher in LDLT patients on days 3 and 5, although they were similar before LT (P ‫؍‬ NS). Alanine aminotransferase (ALT) values were higher among LDLT patients from 8 to 14 days and from 4 to 24 months. Two-year graft and patient survival were 73% for LDLT patients and 80% for DDLT patients (P ‫؍‬ NS). In conclusion, viral load rose more rapidly in LD recipients and reached higher levels shortly after surgery. Greater ALT elevations were evident in the LDLT group, but survival rates were similar. The trend toward a greater initial viral load decrease in patients with LD grafts and the significantly sharper increase suggest that the liver plays a predominant role in both HCV clearance and replication. ( A fter transplantation of hepatitis C virus (HCV) patients, viral infection of the graft is nearly universal, providing a unique opportunity to examine interactions between the human liver and HCV. Grafts from living donors (LDs) differ from grafts from deceased donors (DDs) in characteristics such as the rapid increase in volume that occurs in LD grafts during the first week after surgery. 1 Several studies have compared outcomes of LD liver transplantation (LDLT) and DDLT in HCV patients. [2][3][4][5][6][7][8][9][10][11] Results have been inconsistent, in part, because of differences in experimental design and small sample sizes. 12-17 Concerning survival, no short-term difference was observed in a study of 65 DD versus 35 LD patients, 6 and analysis of the United Network for Organ Sharing liver transplant database showed that the 2-year survival of 279 LD and 3,955 DD recipients was virtually identical. 5 Other analyses of the same database, however, showed that graft survival was lower in LD recipients. 4,8 Studies of biopsy specimens have yielded conflicting results regarding the severity of recurrent hepatitis and the rate of progressive graft injury. 7,10,11 HCV may interact differently with LD grafts than with DD grafts, and this difference may lead to greater LD graft injury. Exceptionally high HCV RNA levels in the early postoperative period are associated with greater long-term liver damage in DDLT patients, 18,19 and a similar association may exist in LDLT patients. The popula-

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“…Advance in liver fibrosis leads to cirrhosis and eventually liver failure which greatly accounts for morbidity and mortality [1,2]. Although orthotropic liver transplantation is currently the only definitive therapeutic option for end-stage liver disease, it has limitations including lack of donor organs, invasiveness of procedure, poor long-term graft survival, requirement of lifelong immunosuppression, and high costs [3,4]. Thus, search for alternative effective therapies and validation of their feasibility are of need.…”

Section: Introductionmentioning

confidence: 99%