Living Related Partial Liver Transplantation in Biliary Atresia: 11 Cases of Experience
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HIROTAKA KATOH1,
NOBUHIRO OHKOHCHI1,
SUSUMU SATOMI1,
SATORU SHIMAOKA2 and
RYOJI OHI2
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1The Second Department of Surgery, 2Department of Pediatric
Surgery, Tohoku University School of Medicine, Sendai 980 - 77
Eleven children, 4 males and 7 females, with biliary atresia receiving living related liver graft
were studied. The mean age was 1.8 years and the mean body weight was 10.3 kg. The
donors were 4 fathers and 7 mothers. The graft was the lateral segment or left lobe. ABO
blood group matching was compatible in 9 and incompatible in 2. All patients except one
were crossmatch negative. Immunosuppression at induction was triple therapy (cyclosporine,
azathioprine and steroid) or FK506 plus steroid. Acute rejection episodes were treated with
pulse steroids. When the signs of rejection persisted despite steroid pulse therapy,
15-deoxyspergualin (DSG) was added. The survival rate of the patients was 73%. Three
patients died of portal vein thrombosis, hepatic artery thrombosis and sepsis respectively.
Other major complications included hyperbilirubinemia, bile duct stenosis, bile leakage and
portal vein anastomosis narrowing. Complications of the donor were sepsis in one, and liver
dysfunction in two. Although there are some complications related to graft size mismatch and
operative procedure, living related partial liver transplantation is an effective therapy in
countries where donor source is restricted.
Key word(s)---
biliary atresia; living related liver transplantation; 15-deoxyspergualin
Tohoku J. Exp. Med., 1997, 181, 139-144
Address for reprints:
Hirotaka Katoh, M.D., The Second Department of Surgery, Tohoku University School of
Medicine, 1-1 Seiryomachi, Aoba-ku, Sendai 980-77, Japan.
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