Choice of transplantation techniques and indications for liver transplantation in polycystic liver disease in patients with no signs of end-stage liver disease

Transplant Proc. 2008 Jun;40(5):1536-8. doi: 10.1016/j.transproceed.2008.02.080.

Abstract

Objective: Since the initiation of the Liver Transplant Program, 500 liver procedures have been performed. Polycystic liver disease (PLD) and polycystic kidney-liver disease (PKLD) have been rare indications for orthotopic liver transplantation (OLT). Only 7 patients (1.4%) underwent transplantation due to PLD and PKLD.

Materials and methods: The group consisted of 4 patients who underwent OLT (0.8%) and 3 patients who received simultaneous liver kidney transplantation (LKT; 0.6%). Our objective was to analyze the indications for either OLT or combined LKT as well as indications for surgical techniques during OLT among patients with PLD or PKLD.

Results: The main indication for OLT was massive hepatomegaly causing severe physical handicaps, fatigue, and clinically advanced malnutrition. All 3 patients with indications for combined LKT were dialysis-dependent. None of the patients had symptoms of end-stage liver disease and/or hepatic failure. In 4 cases, a portal bypass was applied, and the piggy-back method used in the other 3 cases. The hepatectomy caused no uncommon difficulty. In cases of simultaneous transplantations, the kidney was implanted separately after OLT. All patients are alive following the transplantation; major surgical complications have occurred.

Conclusions: Patients with PLD can undergo OLT safely with good results. They benefit from the relief of abdominal distension and anorexia. Patients with PKLD who are dialysis-dependent should undergo simultaneous LKT. The surgical technique was solely dependent on the intraoperative conditions determined during the dissection phase.

MeSH terms

  • Cysts / surgery*
  • Female
  • Follow-Up Studies
  • Hepatomegaly / surgery
  • Humans
  • Kidney Transplantation / methods*
  • Liver Diseases / complications
  • Liver Diseases / surgery*
  • Liver Failure
  • Liver Transplantation / methods*
  • Male
  • Polycystic Kidney Diseases / complications*
  • Polycystic Kidney Diseases / surgery*
  • Treatment Outcome