[Evaluation of the effect of living donor liver transplantation on the treatment of severe hepatitis].

Objective: To evaluate the effect of living donor liver transplantation on the treatment of severe hepatitis.

Methods: 18 patients with severe hepatitis received liver transplantation (transplanted severe hepatitis group), 28 patients with sever hepatitis received non surgical treatment (non-transplanted severe hepatitis group), and 30 patients with end stage liver cirrhosis (without cancer) received liver transplantation (transplanted cirrhosis group). The vital sign, blood coagulation, and renal function were monitored during operation. After liver transplantation, patients received immunosuppressive therapy (including tacrolimus or cyclosporine A, mycophenolate, mofetil and corticosteroids), intensive care, antiviral therapy (including lamivudine and HBIg) and other treatments (including restoration of liver function and prevention of blood coagulation). Pre-operation data, operation procedure, liver function, renal function and the operation complications of three groups were compared, and survival rate at 1, 6 and 12 months after operation was followed.

Results: There was no significant difference in the operation time, warm ischemia time, hypothermic ischemia time and Graft-to-recipient weight ratio between the two transplantation groups. The blood loss volume and blood transfusion volume in the transplanted severe hepatitis group were higher than that those in the cirrhosis transplantation group (t = 0.001, 0.004). The levels of TBil, ALT and AST at day 7 after operation were (100.5 +/- 96.4)mumol/L, (215.3 +/- 195.7) U/L , (209.8 +/- 188.6) U/L in the transplanted severe hepatitis group, and (53.3 +/- 31.9)mumol/L, (56.3 +/- 22.1) U/L, (51.3 +/- 13.5) U/L in the transplanted cirrhosis group (t = 0.017, 0.021, 0.004). However, there was no significant difference in the levels of Alb and Cr between these two groups (P > 0.05). Survival rate was 88.89%, 83.33% 83.33% in the transplanted severe hepatitis group, and 96.67%, 93.33% 93.33% in the transplanted cirrhosis group at 1, 6 and 12 months after transplantation.

Conclusion: Living donor liver transplantation is one of effect ways for the treatment of severe hepatitis.