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Living Related-Donor Liver Transplantation from Adult to Adult for Primary Biliary Cirrhosis
- Takafumi Ichida, MD;
- Hidetoshi Matsunami, MD;
- Seiji Kawasaki, MD;
- Masatoshi Makuuchi, MD;
- Takeshi Harada, MD;
- Shinichi Itoh, MD; and
- Hitoshi Asakura, MD
- From the Niigata University School of Medicine, Niigata City, Japan; and the Shinsyu University School of Medicine, Nagano, Japan. Requests for Reprints: Takafumi Ichida, MD, Third Department of Internal Medicine, Niigata University School of Medicine, 754 Asahimachi-Dori 1, Niigata City, Niigata Japan 951. Grant Support: In part by the Vehicle Racing Commemorative Foundation for the Program of Japanese Survey for the Liver Transplantation.
The shortage of donor cadaveric organs necessitates a continued search for additional options in the treatment of primary biliary cirrhosis, options such as liver xenograft [1] and living related-donor (LRD) liver transplantation [2]. The potential benefit of liver xenograft remains unclear because the procedure has many unresolved immunologic problems [3]. In contrast, LRD liver transplantation can realistically be used to resolve the problems of inadequate pediatric and urgent adult transplantation [4]. For pediatric LRD liver transplantation, a sufficient volume of parental liver can be harvested to guarantee the survival of the pediatric recipient. However, the clinical outcome of LRD liver transplantation done from adult to adult depends on regeneration of the donor liver [5]. We describe an LRD liver transplantation that was done in a 53-year-old woman with primary biliary cirrhosis using a partial liver graft obtained from the woman's 25-year-old son.
Case Report
A 53-year-old woman with a 10-year history of primary biliary cirrhosis presented with pruritus and stage I primary biliary cirrhosis as defined by Scheuer's histologic criteria. She had been treated for 7 years with various therapies, including cholestyramine, ursodeoxycholic acid, penicillamine, and colchicine. In June 1992, her total bilirubin level was 4.275 µmol/L (0.25 mg/dL). She had been treated unsuccessfully with methotrexate or rifampin or both …
