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KMID : 0361120080220010092
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Korean Journal of Transplantation
2008 Volume.22 No. 1 p.92 ~ p.96
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Living Donor Exchange Program for Adult Living Donor Liver Transplantation: Preliminary Experience at the Asan Medical Center, Korea
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Lee Hyo-Jun
Hwang Shin
Lee Sung-Gyu
Ahn Chul-Soo
Kim Ki-Hun
Moon Deok-Bog
Ha Tae-Yong
Song Gi-Won
Park Kwang-Min
Jung Dong-Hwan
Ryu Je-Ho
Park Jeong-Ik
Kim Kwan-Woo
Ko Kyoung-Hun
Choi Nam-Kyu
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Abstract
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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.
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KEYWORD
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Liver transplantation, Living donor, Donor exchange program
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