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Living donor liver transplantation using a graft from a donor with Dubin–Johnson syndrome

Authors

  • Chinsu Liu,

    1. Division of Pediatric Surgery
    2. Division of Transplantation Surgery, Department of Surgery, Taipei Veterans General Hospital
    3. National Yang-Ming University School of Medicine, Taipei
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  • Dau-Ming Niu,

    1. National Yang-Ming University School of Medicine, Taipei
    2. Department of Pediatrics
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  • Cheng-Yuan Hsia,

    1. Division of Transplantation Surgery, Department of Surgery, Taipei Veterans General Hospital
    2. National Yang-Ming University School of Medicine, Taipei
    3. Division of General Surgery
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  • Che-Chuan Loong,

    1. Division of Transplantation Surgery, Department of Surgery, Taipei Veterans General Hospital
    2. National Yang-Ming University School of Medicine, Taipei
    3. Division of General Surgery
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  • Niang-Cheng Lin,

    1. Division of Transplantation Surgery, Department of Surgery, Taipei Veterans General Hospital
    2. National Yang-Ming University School of Medicine, Taipei
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  • Hsin-Lin Tsai,

    1. Division of Pediatric Surgery
    2. Division of Transplantation Surgery, Department of Surgery, Taipei Veterans General Hospital
    3. National Yang-Ming University School of Medicine, Taipei
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  • Mei-Yung Tsou,

    1. National Yang-Ming University School of Medicine, Taipei
    2. Department of Anesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan
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  • Taiwai Chin

    1. Division of Pediatric Surgery
    2. National Yang-Ming University School of Medicine, Taipei
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Chinsu Liu, Division of Pediatric Surgery, Department of Surgery, Taipei Veterans General Hospital, #201, Section 2, Shih-Pai Rd., Taipei 112, Taiwan
Tel.: +886 2 2875 7484
Fax: +886 2 2875 7537
E-mail: csliu@vghtpe.gov.tw

Abstract

Liu C, Niu D-M, Hsia C-Y, Loong C-C, Lin N-C, Tsai H-L, Tsou M-Y, Chin T. Living donor liver transplantation using a graft from a donor with Dubin–Johnson syndrome.
Pediatr Transplantation 2012: 16: E25–E29. © 2010 John Wiley & Sons A/S.

Abstract:  DJS is an autosomal recessive disorder that causes an increase in conjugated bilirubin without elevation of liver enzymes. Most patients are asymptomatic and have normal life spans, but to the best of our knowledge, their livers have never been reported to be grafts in liver transplantation. Herein, we report an infant patient with MMA that received a partial liver graft from his mother, who had DJS. A biliary anastomosis stricture was noted five months after transplantation and was successfully treated with radiological interventions. Otherwise, the patient’s liver functions were normal, and a liver biopsy showed a pathognomonic picture of DJS nine months after the transplantation. The patient was followed for one yr, and the results were satisfactory for an increase in oral intake and protein uptake, no recurrence of metabolic stroke and there was a gradual catch-up with regard to physical development despite having a persistently abnormal profile of amino acid analysis. From the experience of our case, we suggest that a liver from a donor with DJS can be used as a graft for liver transplantation, although long-term follow-up is mandatory to examine the grafted liver under the use of immunosuppressive medications.

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