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Vol. 86. Issue 5.
Pages 278-282 (October 2009)
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Vol. 86. Issue 5.
Pages 278-282 (October 2009)
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Controversies in living donor liver transplants
Controversias en la obtención del injerto hepático procedente de donante vivo
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Juan Carlos García-Valdecasas
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jcvalde@clinic.ub.es

Corresponding author.
, David Calatayud, José Fuster, Constantino Fondevila, Santiago Sánchez, Raquel García, Maria Modolo, Juana Ferrer
Instituto de Enfermedades Digestivas y Metabólicas, Unidad de Cirugía Hepática y Trasplante, Servicio de Cirugía General y Digestiva, Hospital Clínic de Barcelona, Barcelona, Spain
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Abstract

Adult liver transplants from a living donor are a valid and effective alternative as a treatment in terminal liver disease. However, in the context of a donation from a brain dead donor, as in western countries (Spain), it is very high, and there are still controversial aspects that should be continuously assessed in order to ensure good results. Live donations are currently stable and represent about 5% of the total liver transplants performed in Europe. Morbidity and mortality is around 35% and 0.1%, respectively, probably reasonable figures given the characteristics of the intervention. The 1 and 5 year survival rates of the recipients of a living donor are currently 95% and 75%, which are similar to those coming from brain dead donors. However the level of biliary complications in this patient group is higher, with an incidence of around 35%–40%. However, this incidence has not had any effect on the long-term results up until now.

Keywords:
Liver transplant
Live donor
Live adult donor
Live donor recipient
Resumen

El trasplante hepático en adulto con órgano procedente de donante vivo es una alternativa válida y eficaz como tratamiento de la enfermedad terminal hepática. Sin embargo, en el contexto de tasas muy elevadas de órgano procedente de donante en muerte cerebral, como ocurre en los países occidentales (España), continúa manteniendo aspectos controvertidos que obligan a una evaluación continua para asegurar buenos resultados. La donación en vivo se encuentra estabilizada en la actualidad y representa alrededor del 5% de toda la actividad de trasplante hepático en Europa. La morbididad y la mortalidad están alrededor del 35 y el 0,1% respectivamente, cifras probablemente razonables, dadas las características de la intervención. En cuanto a los resultados de los receptores de un donante vivo, las supervivencias a 1 y 5 años actualmente son del 95 y el 75%, lo que los sitúa en cifras similares a los resultados procedentes de donante en muerte cerebral. Sin embargo, el índice de complicaciones biliares en este grupo de pacientes es mayor, con un 35–40% de incidencia, aunque hasta ahora ésta no influye en los resultados a largo plazo

Palabras clave:
Trasplante hepático
Donante vivo
Donante vivo en adulto
Receptor hepático de donante vivos
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Real Decreto 2070/1999, de 30 de diciembre.
Copyright © 2009. Asociación Española de Cirujanos
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