Liver Transplantation.
- Author:
Deok Bog MOON
1
;
Sung Gyu LEE
Author Information
- Publication Type:Review
- Keywords: Liver transplantation; Deceased donor liver transplantation; Living donor liver transplantation
- MeSH: Adult; Asian Continental Ancestry Group; Diabetes Mellitus; Dyslipidemias; Equipment and Supplies; Far East; Humans; Hypertension; Immunosuppression; Kidney Failure, Chronic; Liver; Liver Diseases; Liver Failure, Acute; Liver Transplantation; Obesity; Patient Selection; Survivors; Tissue Donors; Transplants
- From:Gut and Liver 2009;3(3):145-165
- CountryRepublic of Korea
- Language:English
- Abstract: Liver transplantation has become a lifesaving procedure for patients who have chronic end-stage liver disease and acute liver failure. The satisfactory outcome of liver transplantation has led to insufficient supplies of deceased donor organs, particularly in East Asia. Hence, East Asian surgeons are concentrating on developing and performing living-donor liver transplantation (LDLT). This review article describes an update on the present status of liver transplantation, mainly in adults, and highlights some recent developments on indications for transplantation, patient selection, donor and recipient operation between LDLT and deceased-donor liver transplantation (DDLT), immunosuppression, and long-term management of liver transplant recipients. Currently, the same indication criteria that exist for DDLT are applied to LDLT, with technical refinements for LDLT. In highly experienced centers, LDLT for high-scoring (>30 points) Model of End-Stage Liver Disease (MELD) patients and acute- on-chronic liver-failure patients yields comparably good outcomes to DDLT, because timely liver transplantation with good-quality grafting is possible. With increasing numbers of liver transplantations and long- term survivors, specialized attention should be paid to complications that develop in the long term, such as chronic renal failure, hypertension, diabetes mellitus, dyslipidemia, obesity, bone or neurological complications, and development of de novo tumors, which are highly related to the immunosuppressive treatment.
