| Theme |
Debatable Issues in Living-Donor Liver Transplantation |
| Title |
Living-Donor Liver Transplantation for Primary Biliary Cirrhosis |
| Author |
Toshiyuki Itamoto |
Department of Surgery, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Science, Hiroshima University |
| Author |
Hideki Ohdan |
Department of Surgery, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Science, Hiroshima University |
| Author |
Hirotaka Tashiro |
Department of Surgery, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Science, Hiroshima University |
| Author |
Toshimasa Asahara |
Department of Surgery, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Science, Hiroshima University |
| [ Summary ] |
Cases of primary biliary cirrhosis (PBC) now account for 19 % of cases in which adult to adult living donor liver transplantations (LDLT) are performed in Japan, though the ratio has been decreasing year by year. The indications for liver transplantation for PBC patients include liver failure and the presence of intractable symptoms such as pruritus or fatigue. When the estimated probability of mortality calculated using the model from the Japan Liver Transplant Registry reaches 50 %, transplantation should be considered. In addition, transplantation is indicated when original and updated Mayo risk scores are higher than 7 and 8, respectively. The 1, 5 and 10 - year survival rates after LDLT in Japan are 79 %, 74 % and 74 %, respectively, these rates being almost equal to those in UNOS and ELTR. PBC can reoccur in at least 10 % of patients who have undergone transplantation. Clinical symptoms present before transplantation improve within one year after transplantation in 80 % of transplant patients. |