| [ Summary ] |
We examined the indications for and current results after adult-to-adult living donor liver transplantation in Japan. The most common indication is primary biliary cirrhosis. The risk scores, in the Mayo model, adequately reflected the outcome for these patients. Implementation for those patients with conventional or updated Mayo risk scores, exceeding 10 to 12 may be contra-indicated for living donor liver transplantation, because the results for these patients were poor, in our experience. Those patients with liver failure, due to the hepatitis B virus, must be treated with lamivudine or immunoglobulin before and after liver transplantation. Indications of hepatitis C related liver cirrhosis may not indicate favorable conditions for liver transplantation. The control of virus replication after liver transplantation is not easy. Patients with hepatocellular carcinoma were indicated, using Mazzaferro's criteria, in our institution. However a unified indication for hepatocellular carcinoma has not been established. The overall survival rate after liver transplantation in adults is about 70%, which seems not to be satisfactory. Further therapeutic tactics are necessary to improve results. |