Organ Transplantation Research Today is a free monthly online journal that collates and summarizes the latest research about Organ Transplantation, including details on risks, prognosis, procedure, surgery.

Living donor liver transplantation using dual grafts from two donors: a feasible option to overcome small-for-size graft problems?

Soejima Y, Taketomi A, Ikegami T, Yoshizumi T, Uchiyama H, Yamashita Y, Meguro M, Harada N, Shimada M, Maehara Y

Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. ysoejima@surg2.med.kyushu-u.ac.jp

Living donor liver transplantation (LDLT) between adults inevitably implies two potential risks associated with a small-for-size graft for the recipient and small remnant liver for the donor. To overcome these problems, LDLT using dual grafts from two independent donors can be a solution, in which sufficient graft volume can be obtained while preserving donor safety. We present a case of LDLT that was managed successfully by using right and left lobe dual grafts from two donors. The recipient was a large-size male with hepatitis C cirrhosis complicated by multiple hepatocellular carcinomas (HCCs). The first donor donated a right lobe graft and the second donor donated a left lobe plus caudate lobe graft with the middle hepatic vein. Graft function was excellent throughout the course without evidence of small-for-size syndrome. In conclusion, LDLT using dual grafts can be justified in a selected case to avoid small-for-size graft problems without increasing independent donor risks.

Published 7 March 2008 in Am J Transplant, 8(4): 887-92.
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