Living Donor Exchange Program for Adult Living Donor Liver Transplantation: Preliminary Experience at the Asan Medical Center, Korea.
- Author:
Hyo Jun LEE
1
;
Shin HWANG
;
Sung Gyu LEE
;
Chul Soo AHN
;
Ki Hun KIM
;
Deok Bog MOON
;
Tae Yong HA
;
Gi Won SONG
;
Kwang Min PARK
;
Dong Hwan JUNG
;
Je Ho RYU
;
Jeong Ik PARK
;
Kwan Woo KIM
;
Kyung Hoon KO
;
Nam Kyu CHOI
Author Information
1. Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. sglee2@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Liver transplantation;
Living donor;
Donor exchange program
- MeSH:
Adult;
Blood Group Incompatibility;
Critical Care;
Consensus;
Donor Selection;
Emergencies;
Humans;
Korea;
Liver;
Liver Diseases;
Liver Transplantation;
Living Donors;
Phosphatidylethanolamines;
Tissue Donors
- From:The Journal of the Korean Society for Transplantation
2008;22(1):92-96
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: When performing donor screening for living donor liver transplantation (LDLT) for an adult patient with end- stage liver disease, ABO blood group incompatibility is the most common cause of donor exclusion. To cope with this problem without performing ABO-incompatible LDLT, living donor exchange program has been maintained at the Asan Medical Center, Seoul, Korea since September 2003. Here we introduce the clinical experience of 6 cases of adult LDLT allocated by living donor exchange program. METHODS: From February, 1997 to December 2006. 1208 cases of adult LDLT were performed in our institution. Among them, there were 6 cases allocating through donor exchange program to avoid ABO blood group mismatching. Three sets of 2 donor-recipient combination pairs were made after direct one-to-one donor-recipient matching. RESULTS: Two sets of donor exchange LDLT were performed on elective surgery basis, but one in emergency situation. Two living donors and 2 recipients underwent LDLT operations at the same time at the same institution. All 6 living donors recovered well. All of the 6 recipients are doing well to date although 1 recipient had undergone prolonged intensive care for surgical complications. There was no emotional or psychological conflict related to donor exchange program. CONCLUSION: This is the world-first report on donor exchange adult LDLT. Although this is a preliminary report with only 3 sets, donor exchange program for adult LDLT appears to be a feasible modality to promote LDLT. We believe it can be applicable to a wider population of LDLT after widespread consensus formation.
