Background: Liver transplantation is the only effective treatment for the very sick liver failure patients. For the success of liver transplantation, it is better to have good donors for very sick patients. However, liver donation is very short in Asian countries. Liver donor liver transplantation is the only way to rescue the very sick patients. The aim of this study is to examine the results of living donor liver transplantation for the patients with high the model of end-stage liver disease (MELD) scores.

Materials and methods: The living donor liver transplant recipients with MELD score more than or equal to 25 were included in this study. The clinical profiles were recorded and survival rate was calculated.

Results: From June 2004 to Oct. 2012, totally 61 patients receiving ABO-compatible living donor liver transplantation were included in this study. The disease entities for transplantation were 37 for hepatitis B-, 8 for hepatitis C-, 8 for alcoholic liver cirrhosis-, 4 for drug-induced and 4 for other disease-related liver failure. The mean MELD score was 31.4±5.9. Graft-recipient weight ratio was 1.05±0.26%. Among these patients, 13 (21.3%) patients died within 3 months. Ten of them died of infection and multiple organ failure, 2 patients died of acute humoral rejection and one patient died of pulmonary embolism. The 3-month, 1-year and 3-year survival rates were, 76.9%, 68.2% and 61.9%, respectively. MELD and GRWR could not predict patients’ survival.Conclusion: Partial graft transplantation still can be used to rescue very sick patients and achieve 68.2% of one-year survival in this study. Infection is the most etiology to cause early patient death. Conclusively, living donor liver transplantation to rescue very sick patients is feasible, however, infection control is essential.

« Back to 2013 American Transplant Congress