A single institution experience with living donor liver transplantation for acute-on-chronic hepatitis B liver failure

Hepatogastroenterology. 2011 Jul-Aug;58(109):1267-73. doi: 10.5754/hge10148.

Abstract

Background/aims: This study reports our preliminary experience of living donor liver transplantation (LDLT) for patients with acute-on-chronic liver failure (AoCLF) caused by hepatitis B.

Methodology: 47 patients who demonstrated Ao- CLF caused by hepatitis B with mean (±SD) Model for End-Stage Liver Disease scores of 39.2±5.1 were divided by the transplantation group (n=19) and the non-transplantation group (n=28) according to whether or not undergoing LDLT. At the same time, 30 hepatitis B cirrhosis recipients who underwent LDLT and did not reach the criteria of AoCLF were selected as the control group (n=30). In the transplantation group, veno-venous bypass, molecular adsorbent recirculating system (MARS) and continuous renal replacement therapy (CRRT) were introduced. The intraoperative data, post-transplant complications and mortality were analyzed retrospectively.

Results: There were no significant differences in survival rates of 1, 6 and 12 months and the postoperative complications except for pneumonia and diabetes, between the control group and the transplantation group (p>0.05). Recurrence of hepatitis B was not found in the recipients of the control group and the transplantation group.

Conclusions: Right-lobe LDLT may be an effective therapeutic option for patients with acute-on-chronic hepatitis B liver failure.

MeSH terms

  • Adult
  • End Stage Liver Disease / surgery*
  • Female
  • Hepatitis B, Chronic / complications*
  • Humans
  • Immunoglobulins / therapeutic use
  • Immunosuppression Therapy
  • Liver Failure, Acute / surgery*
  • Liver Transplantation*
  • Living Donors*
  • Male
  • Middle Aged

Substances

  • Immunoglobulins
  • hepatitis B hyperimmune globulin