Comparative Study About Early Dynamic Changes Of Liver And Renal Function Between Patients Undergoing Living Donor Liver Transplantation And Cadaver Liver Transplantation

ObjectiveTo compare the early dynamic changes of the liver and renal function and the early complication following liver transplantation based on our own data between patients with living donor liver transplantation and with cadaver liver transplantation in order to choose the proper operation for the specified patient.MethodData was retrospectively collected for all benign disease patients above 18 ages underwent liver transplantation from Jan.2004 to Sep.2006 in liver transplantation center, west china hospital,excluding cases suffering blood disease or renal disease.Totally 95 cases match our criteria.Rank all patients into two groups according to etiological factors,that is, liver failure and liver sclerosis.In either group rank all patients into two sub-groups according to accepted different operations,that is, the living donor liver transplantation and the cadaver liver transplantation.Preoperative variables collected including age,gender,primary diagnosis,MELD scoring,the condition of infection and dialysis, TB, ALT, AST, CREA, PT in the early one day before the operations.Operative data were surgery time,an-hepatic period, the amount of bleeding and the amount of transfusion.Postoperative variables included the early complication and TB, ALT, AST, CREA, PT in the first ,the third, the fifth and the seventh day after the operations.As for the patients underwent living donor liver transplantation,we also collected the data of the graft and recipient weight ratio(GRWR),graft valume(GV) and stand liver valume(GLV).ResultAmong patients underwent living donor liver transplantation,the GRWR were between 0.72% and 1.37%.among these, 16 cases＜1.0% and 3 cases＜0.8% and the GV/SLV were between 31.86% and 62.48%,among these,9 cases＜50% and 2 cases＜40%.There was no small-for-size syndrome occurred.In the liver failure group, the cadaver liver transplantation subgroup was evidently higher than the living donor liver transplantation group about the waiting time and dialysis before surgery ,besides, evidently lower about PT in the fifth day after sugery.In the liver sclerosis group, the cadaver liver transplantation subgroup was also evidently lower than the living donor liver transplantation group about PT in the fifth day after sugery.ConclusionLiving donor liver transplantation could shorten the time of the patients waiting for proper liver, so it made the urgent liver transplantation possible and could decrease the waiting time and dialysis before surgery.when being lack of proper liver, we given priority to living donor liver transplantation for the patients suffering liver failure.As for the patients with liver sclerosis,the living donor liver transplantation can get the same early conclusion by comparision to the cadaver liver transplantation.With modifications of surgical technique,especially the reconstruction of hepatic vein to provide sufficient venous outflow, living donor liver transplantation in adults using fight lobe liver grafts can become a relatively safe procedure and prevent the small-for-size syndrome.