Korean J Transplant.  2023 Nov;37(Suppl 1):S226. 10.4285/ATW2023.F-8147.

Zero mortality in living donor liver transplantation for primary biliary cholangitis in patients with a Model for End-Stage Liver Disease score of <20

• Yanagaki M
• Furukawa K
• Haruki K
• Akaoka M
• Taniai T
• Onda S
• Matsumoto M
• Gocho T
• Ikegami T

• KMID: 2551846
• DOI: http://doi.org/10.4285/ATW2023.F-8147

Abstract

Background
Although primary biliary cholangitis (PBC) is considered a good indication for living donor liver transplantation (LDLT), the postoperative results are not well known.
Methods
At Jikei University Hospital, 14 patients with PBC underwent LDLT from February 2007 to June 2022. We consider PBC with a Model for End-Stage Liver Disease (MELD) score of <20 to be an indication for LDLT. We performed a retrospective analysis of the patients clinical records.
Results
The patients median age was 53 years, and 12 of the 14 patients were female. A right graft was used in five patients, and three ABO-incompatible transplants were performed. The living donors were children in six cases, partners in four cases, and siblings in four cases. The preoperative MELD scores ranged from 11 to 19 (median, 15). The graft-to-recipient weight ratio ranged from 0.8 to 1.1 (median, 1.0). The median operative time for donors and recipients was 481 and 712 minutes, respectively. The median operative blood loss of donors and recipients was 173 and 1,800 mL, respectively. The median postoperative hospital stay of donors and recipients was 10 and 28 days, respectively. All recipients recovered satisfactorily and remained well during a median follow-up of 7.3 years. Three patients underwent a liver biopsy after LDLT because of acute cellular rejection without histological findings of PBC recurrence.
Conclusions
LDLT provides satisfactory long-term survival for patients with PBC who have a graft-to-recipient weight ratio of >0.7 and MELD score of <20 without hepatocellular damage and only portal vein hypertension.