L/I-2 Living related liver transplants: preliminary report on an initial experience in Italy

Introduction:  Living related liver transplantation has become the treatment for many liver diseases. We present our initial analysis on 42 cases of adult-to-adult living related liver transplants (ALRLTs) performed in a single institution in Italy. Materials and methods:  From January 2002 to February 2006, we performed 42 ALRLTs. The donors (age 18 to 53) all had genetic or emotional relationships; they were all ABO-identical or ABO-compatible. Recipients (age 18 to 68) suffered from cirrhosis secondary to viral etiology (n=13), hepatocellular carcinoma on viral cirrhosis (n=21), cystic fibrosis (n=2), primary biliary cirrhosis (n=2), hepatocellular carcinoma on nonviral cirrhosis (n=2), alcoholic cirrhosis (n=1), and metastatic carcinoid to the liver (n=1). Donor liver resection resulted in 40 right hepatectomies and 2 left hepatectomies. Graft body weight ratio was always above 1%; graft implantation was performed with the piggyback technique, and in 32 cases with the use of venovenous bypass. Results:  There was no donor mortality; 4 donors had biliary complications. The actuarial recipient survival rate at 3 years was 89.25% and the graft survival rate was 82.69%. Graft loss occurred in 7 patients: 5 patients underwent retransplants (4 because of hepatic artery thrombosis, 1 because of graft dysfunction), and 2 patients had 1 episode of acute cellular rejection. Conclusion:  ALRLTs represent a resource to face the organ shortage in a region where the deceased donor donation rate is 7.2 donors per year per million.