Domino Liver Transplantation: Risks and Benefits

Abstract Domino liver transplantation, wherein a patient who himself undergoes liver transplantation in turn donates his liver to another recipient, has been performed since the mid-1990s. Although livers from a handful of metabolic disorders cured by liver transplantation have been used for domino...

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Bibliographic Details
Published in:Transplantation proceedings 2008-05, Vol.40 (4), p.1130-1131
Main Authors: Ericzon, B.-G, Larsson, M, Wilczek, H.E
Format: Article
Language:English
Subjects:
Amyloid Neuropathies, Familial - genetics
Amyloid Neuropathies, Familial - surgery
Biological and medical sciences
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Hepatic Artery - anatomy & histology
Humans
Liver Transplantation - adverse effects
Liver Transplantation - methods
Liver, biliary tract, pancreas, portal circulation, spleen
Medical sciences
Medicin och hälsovetenskap
Mutation
Portal Vein - anatomy & histology
Prealbumin - genetics
Reoperation
Risk Assessment
Risk Factors
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Tissue, organ and graft immunology
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Summary:Abstract Domino liver transplantation, wherein a patient who himself undergoes liver transplantation in turn donates his liver to another recipient, has been performed since the mid-1990s. Although livers from a handful of metabolic disorders cured by liver transplantation have been used for domino transplantation, familial amyloidotic polyneuoropathy (FAP) livers are by far the most common source. FAP is an inherited disorder never presenting its clinical manifestation before the age of 15. In many carriers, the genetic disorder never manifests during lifetime. Thus, only a proportion of patients with FAP develop disease symptoms, which has been the rationale for using such livers for other patients on the waiting list for liver transplantation. According to the Familial Amyloidotic Polyneuropathy World Transplant Registry (FAPWTR), only 2 out of more than 500 patients so far have developed symptoms after domino liver transplantation using an FAP liver. Domino recipients with nonmalignant indications for liver transplantation show excellent long-term survivals. With careful selection of recipients, the procedure helps to reduce the organ shortage and the time on the waiting list for patients with malignant disorders.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2008.03.020