Left lobe living donor liver transplantation in adults.

Adult left lobe (LL) living donor liver transplantation (LDLT) has not generally been recognized as a feasible procedure because of the problem of graft size. The objectives of this study were to assess the feasibility and short- and long-term results of adult LL LDLT in comparison with right lobe (RL) LDLT. Data on 200 consecutive LL LDLTs, including five retransplants, were retrospectively compared with those of 112 RL LDLTs, in terms of survival, complications and donor morbidity. The mean graft weight to standard volume ratio of LL grafts was 38.7% whereas that of RL grafts was 47.6% (p < 0.0001). The 1-, 5- and 10-year patient survival rates of LL LDLT were 85.6%, 77.9% and 69.5%, respectively, which were comparable to those of RL LDLT (89.8%, 71.3% and 70.7%, respectively). The incidence of small-for-size syndrome was higher in LL LDLT (19.5%) than in RL LDLT (7.1%) (p < 0.01). The overall donor morbidity rates were comparable between LL (36.0%) and RL (34.8%), whereas postoperative liver function tests and hospital stay were significantly better (p < 0.0001) in LL donors. In conclusion, adult LL LDLT has comparable outcomes to that of RL LDLT. LL LDLT is viable and is the first choice in adult LDLT.

Soejima Y ，Shirabe K ，Taketomi A ，Yoshizumi T ，Uchiyama H ，Ikegami T ，Ninomiya M ，Harada N ，Ijichi H ，Maehara Y ... -  《-》

Outcomes of right-lobe and left-lobe living-donor liver transplantations using small-for-size grafts.

She WH ，Chok KS ，Fung JY ，Chan AC ，Lo CM ... -  《-》

Feasibility of left lobe living donor liver transplantation between adults: an 8-year, single-center experience of 107 cases.

Soejima Y ，Taketomi A ，Yoshizumi T ，Uchiyama H ，Harada N ，Ijichi H ，Yonemura Y ，Shimada M ，Maehara Y ... -  《AMERICAN JOURNAL OF TRANSPLANTATION》

The long-term outcomes of patients with hepatocellular carcinoma after living donor liver transplantation: a comparison of right and left lobe grafts.

Taketomi A ，Shirabe K ，Toshima T ，Morita K ，Hashimoto N ，Kayashima H ，Ikegami T ，Yoshizumi T ，Soejima Y ，Maehara Y ... -  《-》

Is left lobe adult-to-adult living donor liver transplantation ready for widespread use? The US experience (1998-2010).

Living donor liver transplantation (LDLT) is an accepted treatment for patients with end-stage liver disease. To minimize risk to the donor, left lobe (LL) LDLT may be an ideal option in adult LDLT. This study assessed the outcomes of LL-LDLT compared with right lobe (RL) LDLT in adults (1998-2010) as reported to the United Network for Organ Sharing (UNOS) Organ Procurement and Transplantation Network (OPTN). A total of 2844 recipients of LDLT were identified. Of these, 2690 (94.6%) underwent RL-LDLT and 154 (5.4%) underwent LL-LDLT. A recent increase in the number of LL-LDLTs was noted: average numbers of LL-LDLTs per year were 5.2 during 1998-2003 and 19.4 during 2004-2010. Compared with RL-LDLT recipients, LL-LDLT recipients were younger (mean age: 50.5 years vs. 47.0 years), had a lower body mass index (BMI) (mean BMI: 24.5 kg/m(2) vs. 26.8 kg/m(2)), and were more likely to be female (64.6% vs. 41.9%). Donors in LL-LDLT had a higher BMI (mean BMI: 29.4 kg/m(2) vs. 26.5 kg/m(2)) and were less likely to be female (30.9% vs. 48.1%). Recipients of LL-LDLT had a longer mean length of stay (24.9 days vs. 18.2 days) and higher retransplantation rates (20.3% vs. 10.9%). Allograft survival in LL-LDLT was significantly lower than in RL-LDLT and there was a trend towards inferior patient survival. In Cox regression analysis, LL-LDLT was found to be associated with an increased risk for allograft failure [hazard ratio (HR): 2.39)] and inferior patient survival (HR: 1.86). The number of LL-LDLTs has increased in recent years.

Saidi RF ，Jabbour N ，Li Y ，Shah SA ，Bozorgzadeh A ... -  《-》