Living donor liver transplantation from an asymptomatic mother who was a carrier for ornithine transcarbamylase deficiency

Wakiya T, Sanada Y, Urahashi T, Ihara Y, Yamada N, Okada N, Egami S, Sakamoto K, Murayama K, Hakamada K, Yasuda Y, Mizuta K. Living donor liver transplantation from an asymptomatic mother who was a carrier for ornithine transcarbamylase deficiency. :  Liver transplantation (LT) has been adopted as a...

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Published in:Pediatric transplantation 2012-09, Vol.16 (6), p.E196-E200
Main Authors: Wakiya, T., Sanada, Y., Urahashi, T., Ihara, Y., Yamada, N., Okada, N., Egami, S., Sakamoto, K., Murayama, K., Hakamada, K., Yasuda, Y., Mizuta, K.
Format: Article
Language:English
Subjects:
Adult
Biopsy
Female
Graft Survival
Heterozygote
heterozygous donor
Humans
Infant
Infant, Newborn
Liver - enzymology
Liver - pathology
Liver Transplantation - methods
living donor liver transplantation
Living Donors
Male
Mothers
Ornithine Carbamoyltransferase Deficiency Disease - diagnosis
Ornithine Carbamoyltransferase Deficiency Disease - genetics
ornithine transcarbamylase activity
ornithine transcarbamylase deficiency
Pedigree
Treatment Outcome
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Summary:Wakiya T, Sanada Y, Urahashi T, Ihara Y, Yamada N, Okada N, Egami S, Sakamoto K, Murayama K, Hakamada K, Yasuda Y, Mizuta K. Living donor liver transplantation from an asymptomatic mother who was a carrier for ornithine transcarbamylase deficiency. :  Liver transplantation (LT) has been adopted as a radical treatment for ornithine transcarbamylase deficiency (OTCD), yielding favorable outcomes. Despite the fact that it is an inheritable disease, a blood relative who is heterozygous for the disorder must sometimes be used as a liver donor for living donor LT. There is ongoing discussion regarding the use of heterozygous donors, however, to our knowledge, no cases where donation was determined based on the Ornithine transcarbamylase (OTC) activity before LT have been reported. Between May 2001 and April 2011, 17 patients were indicated for living donor LT because of OTCD at our facility. There were three cases with heterozygous donor candidate (17.6%). All heterozygous candidates underwent a liver biopsy to measure their OTC activity before LT and made efforts to secure the safety of the both donor and recipient. Two of 3 candidates had headaches sometimes, and their activity was less than 40%, and thus they were not employed as the donor. One candidate with 104.4% activity was employed, yielding favorable outcomes. Our current experience supported the effectiveness of our donation criteria, however it is necessary to collect sufficient data on a large number of patients to confirm the safety of the procedure.
ISSN:1397-3142
1399-3046
DOI:10.1111/j.1399-3046.2012.01716.x