Review
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Sep 7, 2008; 14(33): 5105-5109
Published online Sep 7, 2008. doi: 10.3748/wjg.14.5105
Recurrence of cholestatic liver disease after living donor liver transplantation
Sumihito Tamura, Yasuhiko Sugawara, Junichi Kaneko, Junichi Togashi, Yuichi Matsui, Noriyo Yamashiki, Norihiro Kokudo, Masatoshi Makuuchi
Sumihito Tamura, Yasuhiko Sugawara, Junichi Kaneko, Junichi Togashi, Yuichi Matsui, Noriyo Yamashiki, Norihiro Kokudo, Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
Masatoshi Makuuchi, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan
Author contributions: Tamura S and Sugawara Y designed the study and wrote the paper; Kaneko J, Togashi J, Matsui Y, Yamashiki N and Kokudo N performed the study; Makuuchi M supervised the project.
Supported by A Grant-in-aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan and Grants-in-aid for Research on HIV/AIDS and Research on Measures for Intractable Diseases from the Ministry of Health, Labor and Welfare of Japan, No. B18390341
Correspondence to: Yasuhiko Sugawara, MD, Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. yasusuga-tky@umin.ac.jp
Telephone: +81-3-38155411 Fax: +81-3-56843989
Received: January 30, 2008
Revised: July 25, 2008
Accepted: August 1, 2008
Published online: September 7, 2008
Abstract

End-stage liver disease, due to cholestatic liver diseases with an autoimmune background such as primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC), is considered a good indication for liver transplantation. Excellent overall patient and graft outcomes, based mostly on the experience from deceased donor liver transplantation (DDLT), have been reported. Due to the limited number of organ donations from deceased donors in most Asian countries, living donor liver transplantation (LDLT) is the mainstream treatment for end-stage liver disease, including that resulting from PBC and PSC. Although the initial experiences with LDLT for PBC and PSC seem satisfactory or comparable to that with DDLT, some aspects, including the timing of transplantation, the risk of recurrent disease, and its long-term clinical implications, require further evaluation. Whether or not the long-term outcomes of LDLT from a biologically related donor are equivalent to that of DDLT requires further observations. The clinical course following LDLT may be affected by the genetic background shared between the recipient and the living related donor.

Keywords: Liver transplantation; Primary biliary cirrhosis; Primary sclerosing cholangitis; Living donor; Recurrence