Dou K, Wang D, Tao K, Yue S, Ti Z, Song Z, Li L, He Y, Hou X

Language: English
References: 21
Page: 399-403
PDF size: 192.08 Kb.

ABSTRACT

Liver transplantation is regarded as an effective treatment for Wilson’s disease (WD), and recently has been shown to improve not only hepatic but also neurologic manifestations. Conventional auxiliary liver transplantation for WD is orthotopic liver transplantation and heterotopic liver transplantation. But the conventional procedure could not avoid the problem of space, functional competition, hemodynamic variation. Here we report a case of heterotopic auxiliary living-donor liver transplantation (HALDLT) to treat WD. We modified the operation to have a splenectomy, implant graft into the splenic fossa. The patient recovered well after the transplantation and has been symptom-free during a 5-year follow-up. This modified operation is more safe and simple. HALDLT might be an effective treatment for WD patients with splenomegaly.

REFERENCES

1. Busuttil RW, Seu P, Millis JM, Olthoff KM, Hiatt JR, Milewicz A, Nuesse B, et al. Liver transplantation in children. Ann Surg 1991; 213: 48-57.

2. Whitington PF, Balisteri WF. Liver transplantation in pediatrics: Indications, contraindications and pretransplant management. J Pediatr 1991; 118: 169-77.

3. Stracciari A, Tempestini A, Borghi A, Guarino M. Effect of liver transplantation on neurological manifestations in Wilson disease. Arch Neuro 2000; l57: 384-6.

4. Chen CL, Chen YS, Lui CC, Hsu SP. Neurological improvement of Wilson’s disease after liver transplantation. Transplant Proc 1997; 29: 497-8.

5. Mason AL, Marsh W, Alpers DH. Intractable neurological Wilson’s disease treated with orthotopic liver transplantation. Digest Dis Sci 1993; 38: 1746-50.

6. Stampfl DA, Muñoz SJ, Moritz MJ, Rubin R, Armenti VT, Jarrell BE, Maddrey WC. Heterotopic liver transplantation for fulminant Wilson’s disease. Gastroenterology 1990; 99: 1834-6.

7. Ferenci P. Diagnosis and current therapy of Wilson’s disease. Aliment Pharmacol Ther 2004; 19: 157-65.

8. Urata K, Kawasaki S, Matsunami H, Hashikura Y, Ikegami T, Ishizone S, Momose Y, et al. Calculation of child and adult standardliver volume for liver transplantation. Hepatology 1995; 21: 1317-21.

9. Tanaka K, Uemoto S, Tokunaga Y, Fujita S, Sano K, Nishizawa T, Sawada H, et al. Surgical techniques and innovations in living-related liver transplantation. Ann Surg 1993; 217: 82-91.

10. Haberal M, Dalgic A. New concepts in organ transplantation. Transplant Proc 2004; 36: 1219-24.

11. Haberal M, Emiroglu R, Dalgiç A, Karakayli H, Moray G, Bilgin N. The impact of cyclosporine on the development of immunosuppressive therapy. Transplant Proc 2004, 36 (suppl.): 143S-147S.

12. Silva-Neto WDB, Cavarzan A, Herman P. Intra-operative of portal pressure and immediate results of surgical treatment of portal hypertension in schistosomotic patients submitted to esophagogastric devascularization with splenectomy. Arq Gastroenterol 2004; 41: 150-4.

13. DuBois RS, Giles G, Rogerson DO, Lilly J, Martineau G, Halgrimson CG, et al. Orthotopic liver transplantation for Wilson’s disease. Lancet 1971; 1: 505-8.

14. Schumacher G, Platz KP, Mueller AR, Neuhaus R, Steinmüller T, Bechstein WO, Becker M, et al. Liver transplantation: treatment of choice for hepatic and neurological manifestations of Wilson’s disease. Clin Transplantation 1997; 11: 217-24.

15. Emre S, Atillasoy EO, Ozdemir S, Schilsky M, Rathna Varma CV, Thung SN, Sternlieb I, et al. Orthotopic liver transplantation for Wilson’s disease. Transplantation 2001; 72: 1232-6.

16. Asonuma K, Inomata Y, Kasahara M, Uemoto S, Egawa H, Fujita S, Kiuchi T, et al. Living related liver transplantation fromheterozygote genetic carriers to children with Wilson’s disease. Pediatr Transplant 1999: 3: 201-5.

17. Wang XH, Cheng F, Zhang F, Li XC, Qian JM, Kong LB, et al. Copper metabolism after living related liver transplantation for Wilson’s disease. World J Gastroenterol 2003: 9: 2836-8.

18. Kasahara M, Takada Y, Egawa H, Fujimoto Y, Ogura Y, Ogawa K, Kozaki K, et al. Auxiliary partial orthotopic living donor liver transplantation: Kyoto University experience. Am J Transpl 2005; 5: 558-65.

19. Schleimer K, Stippel DL, Kasper HU, Allwissner R, Yavuzyasar S, Hölscher AH, Beckurts KT. Beckurts. Competition between native liver and graft in auxiliary liver transplantation in a rat model. Transplantation Proceedings 2008, 40: 967-70.

20. Hasegawa K, Sugawara Y, Makuuchi M. Which is better to overcome the portal steal phenomenon in auxiliary partial orthotopic liver transplantation: inflow or outflow occlusion? Liver Transpl 2006; 12: 692-3.

21. Murata K, Ito K, Yoneda K, Shiraki K, Sakurai H, Ito M. Splenectomy improves liver function in patients with liver cirrhosis. Hepatogastroenterology 2008; 55: 1407-11.