Date: Tuesday, June 4, 2019
Session Time: 2:30pm-4:00pm
Presentation Time: 2:30pm-2:42pm
Location: Room 312
*Purpose: To review single center’s experiences in living donor liver transplantation (LDLT) and analyze risk factors affecting short and long-term outcomes.
*Methods: Retrospective analysis of 5,000 LDLTs by the review of medical records.
*Results: From Dec 1914 to Aug 2018, we’ve done 5000 LDLT including 4,726 adult and 274 pediatric LDLTs. The mean age of recipients was 48.8 years (3 months~72 years) and 72.9% were males. In adult patients, HBV-related ESLD was the most common original disease accounting for 70%. ALC was 2nd (12%) and HCV 3rd (6%). In the pediatric group, BA was the most common cause (47%). The mean PELD and MELD was 19 and 17.7, respectively. And, 8% of patients showed high MELD over 34. The most common graft type used was MRL (75%). We used LL graft in 509 patients (10.2%) and dual graft in 499 (10.0%) patients. The mean graft-to-recipient’s body weight was 1.10% in RL, 1.06% in dual and 0.87% in LL. The mean OP time and transfusion requirements was 13.8 hours and 11.2 units of RBC. The overall in-hospital mortality was 4.2%. The 1, 5 and 10-year overall graft survival rate was 92.4, 86.4 and 83.6%, respectively. The 1,5 and 10-year patient’s survival rate was 93.0, 87.0 and 84.8%, respectively. In the early death (within 1year), infection was the most common cause. In the multivariate analysis, MELD, preoperative patient’s conditions including ICU stay, preoperative use of ventilator, hemodialysis and vasopressor were significant risk factors for survival. But, HCC recurrence, de novo malignancy and recurrence of HCV were independent risk factor for long-term survival. The most common surgical complication after LDLT was biliary stricture with incidence of 18.2%. The postoperative bleeding was 2nd common (16.9%) and hepatic vein stenosis was 3rd (5.3%). The overall incidence of biopsy-proven in 5,000 LDLT was 18%. Among 5,499 living donors, 67.3% were males. The mean age was 29.4 years and oldest one was 72 years. In the relationships between donor and recipients, 62.7% were sibling in adult LDLT and 84.4% were parents in pediatric LDLTs. The overall incidence of major complication in living donor hepatectomy including 91 pure laparoscopic donor hepatectomies were 3.2% and we had no donor mortality.
*Conclusions: Living donor liver transplantation is effective treatment in the country with the scarcity of deceased donor.
To cite this abstract in AMA style:Song G, Lee S, Hwang S, Kim K, Ahn C, Moon D, Ha T, Jung D, Park G, Yoon Y, Kwon J, Cho H, Jung Y, Kang S, Jeong I, Choi J. 5,000 Living Donor Liver Transplantations [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/5000-living-donor-liver-transplantations/. Accessed December 13, 2019.
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