Información del artículo
Resumen
El trasplante hepático de donante vivo representa una alternativa válida que puede permitir ofrecer este tratamiento a un mayor número de pacientes y, al mismo tiempo, reducir la mortalidad en las listas de espera. Los resultados apuntan a un riesgo aceptable para el donante, aunque en opinión de algunos autores falta por demostrar su verdadera eficacia y una supervivencia adecuada para el receptor. La complejidad de la intervención tanto en el donante como en el receptor hace que haya que ser muy prudente a la hora de iniciar un programa de este tipo, y sólo los grupos con experiencia probada en resecciones hepáticas y a su vez en trasplante hepático pueden abordar este reto con suficientes garantías
Palabras clave:
Trasplante hepático
Transplante hepático de donante vivo
Humano
Cirugía
Living donor liver transplantation is a valid alternative that may enable a greater number of patients to undergo transplantation and may, in turn, reduce mortality among patients on the waiting list. The results show that the risk to the donor is acceptable survival for the recipient remain to be demonstrated. Because of the complexity of the intervention, both in the donor and in the receptor, caution should be exercised before initiating a program of this type. Only surgical teams with proven experience in hepatic resection and liver transplantation can approach this challenge with sufficient guarantees
Key words:
Liver transplantation
Living related liver transplantation
Human
Surgery
El Texto completo está disponible en PDF
Bibliografía
[1.]
ELTR Coordinating Committee. European Liver Transplant Registry. June 2000 (GENERIC). Disponible en: http://www.eltr.org
[2.]
Organización Nacional de Trasplantes. Registro Español de Trasplante Hepático. Organización Nacional de Trasplante. Diciembre 2000. Ministerio de Sanidad y Consumo. Disponible en: http://msc.es/ont/RETH
[3.]
C.E. Broelsch, M. Burdelski, X. Rogiers, M. Gundlach, W.T. Knoefel, T. Langwieler, et al.
Living donor for liver transplantation.
Hepatology, 20 (1994), pp. 49S-55S
[4.]
J.C. Bucuvalas, F.C. Ryckman.
The long-and-short-term outcome of living-donor liver transplantation.
J Pediatrics, 134 (1999), pp. 259-261
[5.]
J.C. Emond, P. Rosenthal, J.P. Roberts, P. Stock, S. Kelley, G. Gregory, et al.
Living related donor liver transplantation: the UCSF Experience.
Transplant Proc, 28 (1996), pp. 2375-2377
[6.]
T.G. Heffron, A.N. Langnas, I.J. Fox, D. Mack, A. Dhawan, S. Kaufman, et al.
Living related donor liver transplantation at the University of Nebraska Medical Center (1996).
Transplant Proc, 28 (1996), pp. 2382
[7.]
O. Jurim, C.R. Shackleton, S.V. McDiarmid, P. Martin, A. Shaked, J.M. Millis, et al.
Living-donor liver transplantation at UCLA.
Am J Surg, 169 (1995), pp. 529-532
[8.]
J.B. Otte, J. De Ville de Goyet, R. Reding, E. Sokal, J. Lerut, P. Vanormelingen, et al.
Living related donor liver transplantation in children: The Brussels Experiencie.
Transplant Proc, 28 (1996), pp. 2378-2379
[9.]
J.B. Piper, P.F. Whitington, E.S. Woodle, K.A. Newell, E.M. Alonso, J.C. Emond, et al.
Pediatric liver transplantation at the University of Chicago Hospitals.
Clin Transplants, (1992), pp. 179-189
[10.]
R.W. Strong, S.V. Lynch, T.H. Ong, H. Matsunami, Y. Koido, G.A. Balderson.
Succesful liver transplantation from a living donor to her son.
N Engl J Med, 322 (1990), pp. 1505-1507
[11.]
P.A. Singer, M. Siegler, P.F. Whitington, J.D. Lantos, J.C. Emond, J.R. Thistlethwaite, et al.
Ehtics of liver transplantation with living donors.
N Engl J Med, 321 (1989), pp. 620-621
[12.]
M. Malago, X. Rogiers, C.E. Broelsch.
Liver splitting and living donor techniques.
Brit Med Bull, 53 (1997), pp. 860-867
[13.]
X. Rogiers, M. Malago, K. Gaward, K.W. Jauch, M. Olausson, W.T. Knoefel, et al.
In situ splitting of cadaveric livers. The ultimate expansion of a limited donor pool.
Ann Surg, 224 (1996), pp. 331-341
[14.]
S.T. Fan, C.M. Lo, C.l. Liu.
Donor hepatectomy for living-donor liver transplantation.
Hepato-Gastroenterology, 45 (1998), pp. 34-39
[15.]
C.M. Lo, S.T. Fan, C.L. Liu, R.J. Lo, G.K. Lau, W.I. Wei, et al.
Extending the limit on the size of adult recipient in living donor liver transplantation using extended right lobe graft.
Transplantation, 63 (1997), pp. 1524-1528
[16.]
K. Tanaka, S. Fujita, Y. Inomata, S. Uemoto, K. Asonuma, H. Egawa, T. Kiuchi.
Surgical aspects of right lobe grafting in living donor liver transplantation. Actas de Sixth Congress of the European Society for Organ Transplantation.
Oslo: European Society for Organ Transplantation, 1 (1999), pp. 183
[17.]
H. Higashiyama, N. Yamaguchi, K. Mori, Y. Nakano, T. Yokoyama, T. Takeuchi, et al.
Graft size assessment by preoperative computed tomography in living related partial liver transplantation.
Brit J Surg, 80 (1993), pp. 489-492
[18.]
T. Hirose, T. Inomoto, M. Awane, Y. Shirakata, T. Nada, F. Moriyasu, et al.
Direct measurement of graft and recipient liver fosa size by computed tomography for avoiding problems clue to large graft size in living related liver transplantation.
Clin Transplant, 12 (1998), pp. 49-55
[19.]
K. Urata, S. Kawasaki, H. Matsunami, Y. Hashikura, T. Ikegami, S. Ishizone, et al.
Calculation of child and adult standard liver volume for liver transplantation.
Hepatology, 21 (1995), pp. 1321
[20.]
T.G. Heffron, A.N. Langnas, A.J. Matamoros, J.C. Anderson, D.R. Mack, T.M. McCashland, et al.
Preoperative estimation in living related donor transplantation: clinical correlation and donor/recipient ratio.
Transplant Proc, 28 (1996), pp. 2370
[21.]
C.M. Lo, S.T. Fan, J.K. Chan, W. Wei, R.J. Lo, C.L. Lau.
Minimun graft volume for sucessful adult-to-adult living donor liver transplantation for fulminant hepatic failure.
Transplantation, 62 (1996), pp. 696-698
[22.]
T. Nishizaki, T. Ikegami, S. Hiroshige, K. Hashimoto, H. Uchiyama, T. Yoshizumi, et al.
Small graft for living donor liver transplantation.
Ann Surg, 233 (2001), pp. 575-580
[23.]
J.F. Renz, C.L. Mudge, M.B. Heyman, S. Tomlanovich, R.P. Kingsford, B.J. Moore, et al.
Donor selection limits use of living related liver transplantation.
Hepatology, 22 (1995), pp. 1122-1126
[24.]
T. Kiuchi, M. Kasahara, K. Uryuhara, Y. Inomata, S. Uemoto, K. Asonuma, et al.
Impact of graft size mismatching on graft prognosis in liver transplantation from living donors.
Transplantation, 67 (1999), pp. 321-327
[25.]
S. Takano, T. Tanaka, S. Iwsai.
A new technique of hepatic vein reconstruction in living related liver transplantation.
International Surg, 83 (1998), pp. 324-326
[26.]
R. Adam, D. Castaing, H. Bismuth.
Transplantation of small donor livers in adult recipients.
Transplant Proc, 25 (1993), pp. 1105-1106
[27.]
S. Furuta, T. Ikegami, Y. Nakazawa, Y. Hashikura, H. Matsunami, S. Kawasaki, et al.
Hepatic artery reconstruction in living donor liver transplantation from the microsurgeon’s point of view.
Liver Transplantation & Surgery, 3 (1997), pp. 388-393
[28.]
T. Inomoto, F. Nishizawa, H. Sasaki, H. Terajima, Y. Shirakata, S. Miyamoto, et al.
Experience of 120 microsurgical reconstructions of hepatic artery in living related liver transplantation.
Surgery, 119 (1996), pp. 20-26
[29.]
K. Mori, I. Nagata, S. Yamagata, H. Sasaki, F. Nishizawa, Y. Takada, et al.
The introduction of microvascular surgery to hepatic artery reconstruction in living-donor liver transplantation –its surgical advantages compared with conventional procedures.
Transplantation, 54 (1992), pp. 263-268
[30.]
Y. Harihara, M. Makuuchi, Y. Sakamoto, Y. Sugawara, K. Inoue, M. Hirata, et al.
A simple method to confirm patency of the graft bile duct during living related partial liver transplantation.
Transplantation, 64 (1997), pp. 535-537
[31.]
R. Noun, J.D. Singlant, J. Belghiti.
A practical method for quick assessment of bile duct patency during hepatic resection.
J Am Coll Surgeons, 183 (1996), pp. 77-78
[32.]
H.N. Blansfield.
The ethics of organ transplantation.
Connecticut Medicine, 62 (1998), pp. 367
[33.]
F.D. Moore.
The desperate case: CARE (Costs, Aplicability, Research, Ethics).
JAMA, 261 (1989), pp. 1483-1484
[34.]
F.D. Moore.
Three ethical revolutions: ancient assumptions remodeled under pressure of transplantation.
Transplant Proc, 20 (1988), pp. 1067
[35.]
A.D. Mayer.
The argument against live-donor liver transplantation.
J Hepatol, 24 (1996), pp. 628-630
[36.]
R.W. Strong.
Whither living donor liver transplantation.
Liver Transplantation & Surgery, 5 (1999), pp. 536-538
[37.]
Y. Panis, C. Penna, A. Sauvanet, J. Belghiti.
Surgical results of left lobectomy and left hepatectomy in 70 noncirrhosis patients. A preliminary evaluation before performing liver transplantation from living related donor.
Transplant International, 6 (1993), pp. 293-295
[38.]
Y. Yamaoka, T. Morimoto, T. Inamoto, A. Tanaka, K. Honda, I. Ikai, et al.
Safety of the donor in living related liver transplantation. An analysis of 100 parental donors.
Transplantation, 59 (1995), pp. 224-226
[39.]
R.S. Brown Jr.
National Institute of Health, (2000),
[40.]
C.M. Lo, S.T. Fan, C.L. Liu, W.I. Wei, R.J. Lo, C.L. Lai, et al.
Adult-to-adult living donor liver transplantation using extended right lobe grafts.
Ann Surg, 226 (1997), pp. 261-269
[41.]
Ley de Extracción y Trasplante de Órganos. Boletín Oficial del Estado 1979:2655.
[42.]
Ley de Extracción y Trasplante de Órganos (Real Decreto 2070/1999). Boletín Oficial del Estado 2000:179-90
[43.]
T. Kiuchi, Y. Inomata, S. Uemoto, K. Asonuma, H. Egawa, S. Fujita, et al.
Evolution of living donor liver transplantation in adults: a single center experience of 60 cases. Actas del Sixth Congress of the European Society for Organ Transplantation.
Oslo: European Society for Organ Transplantation, 1 (1999), pp. 240
[44.]
A. Marcos, R.A. Fisher, J.M. Ham, M.L. Shiffman, A.J. Sanyal, V.A. Luketic, et al.
Right lobe living donor liver transplantation.
Transplantation, 68 (1999), pp. 798-803
[45.]
Malago M, Broelsch CE. Adult living donor liver transplantation. [inédito]. The Essen experience. 1999.
[46.]
S. Kawasaki, M. Makuuchi, H. Matsunami, Y. Hashikura, T. Ikegami, Y. Nakazawa, et al.
Living related liver transplantation in adults.
Ann Surg, 227 (1998), pp. 269-274
[47.]
T. Kiuchi, K. Tanaka.
Living related donor liver transplantation: status quo in Kyoto, Japan.
Transplant Proc, 30 (1998), pp. 687-691
[48.]
J.C. García-Valdecasas, J. Fuster, L. Grande, C. Fondevila, A. Rimola, M. Navasa, et al.
Trasplante hepático en adulto de donante vivo. Resultados iniciales.
Gastroenterol Hepatol, 24 (2001), pp. 275-280
[49.]
D.C. Cronin, J.M. Millis, M. Siegler.
Transplantation of liver grafts from living donor into adults-too much, too soon.
N Engl J Med, 344 (2001), pp. 1633-1637
Copyright © 2002. Asociación Española de Cirujanos
