Liver transplantation for metabolic liver disease: experience at a living donor dominant liver transplantation center

Abstract

Purpose: Metabolic liver disease (MLD) often progresses to life-threatening conditions. This study intends to describe the outcomes of liver transplantation (LTx) for MLD at a living donor-dominant transplantation center where potentially heterozygous carrier grafts are employed.

Methods: We retrospectively evaluated the medical records of 54 patients with MLD who underwent LTx between November 1995 and February 2012 at Asan Medical Center in Seoul, Korea. The cumulative graft and patient survival rates were analyzed according to patient age, and living or deceased donor LTx. Recurrence of the original disease was also investigated.

Results: The post-transplant cumulative patient survival rates at one, five, and 10 years were 90.7%, 87.5% and 87.5%, and the graft survival rates were 88.8%, 85.5%, and 85.5%, respectively. There were no differences in the patient survival rates according to the recipient age, human leukocyte antigen matching, and living or deceased donor LTx. There were also no differences in the patient survival rates between the MLD and the non-MLD groups for children. Recurrence of the original metabolic disease was not observed in any patient during the follow-up period.

Conclusion: Our results suggest that the living donor-dominant transplantation program is well-tolerated in MLD without recurrence of the original MLD using all types of transplantation.

Keywords: Adult; Child; Liver transplantation; Metabolic diseases.

Fig. 1. Cumulative post-transplant patient and graft survival rates for 54 patients with metabolic liver diseases.

Fig. 2. (A) Comparison of post-transplant patient survival between the metabolic liver disease (MLD) group (n=23) and the non-MLD group (n=220) in the pediatric age group. (B) Comparison of the post-transplant patient survival among the living donor types (haplo-matched donors [n=18], unrelated donors [n=17], mixed donors [n=7]). (C) Comparison of the post-transplant patient survival between the living donors (n=42) and the cadaveric donors (n=12).