A Single Institution Experience with Living Donor Liver Transplantation for Acute-on-Chronic Hepatitis B Liver Failure

Background/Aims: This study reports our preliminary experience of living donor liver transplantation (LDLT) for patients with acute-on-chronic liver failure (AoCLF) caused by hepatitis B. Methodology: 47 patients who demonstrated AoCLF caused by hepatitis B with mean (+/- SD) Model for End-Stage Liver Disease scores of 39.2 +/- 5.1 were divided by the transplantation group (n=19) and. the non-transplantation group (n=28) according to whether or not undergoing LDLT. At the same time, 30 hepatitis B cirrhosis recipients who underwent LDLT and did not reach the criteria of AoCLF were selected as the control group (n=30). In the transplantation group, veno-venous bypass, molecular adsorbent recirculating system (MARS) and continuous renal replacement therapy (CRRT) were introduced. The intraoperative data, post-transplant complications and mortality were analyzed retrospectively. Results: There were no significant differences in survival rates of 1, 6 and 12 months and the postoperative complications except for pneumonia and diabetes, between the control group and the transplantation group (p>0.05). Recurrence of hepatitis B was not found in the recipients of the control group and the transplantation group. Conclusions: Right-lobe LDLT may be art effective therapeutic option for patients with acute-on-chronic hepatitis B liver failure.