Living Donor Liver Transplantation in an Elderly Recipient with Preserved Performance Status : A Case Report
- Publication date
- Publisher
- 福岡医学会
Abstract
Background : Living donor liver transplantation (LDLT) in an elderly recipient is controversial. Case presentation : We report a case of LDLT in a 74-year-old female who had decompensated liver cirrhosis and hepatocellular carcinoma (HCC). She was the oldest recipient who received LDLT in Japan ever. She was rejected for LDLT at a nearby hospital because of her age.We decided to perform LDLT because her general condition was good (the Eastern Cooperative Oncology Group (ECOG) performance status 2 ). The surgery was uncomplicated and the postoperative course was uneventful, and the patient was discharged 35 days after the surgery. Currently she is living at home, and she has maintained a good quality of life. Conclusions : We believe that a recipient in good general condition is capable of undergoing LDLT despite advanced age.【はじめに】高齢者に生体肝移植を行うべきかどうかについては,議論のあるところである.【症例】74 歳女性.検診で肝機能異常を指摘され,原発性胆汁性肝硬変と診断,経過観察されていた.その後肝予備能が低下し,他院にて生体肝移植が検討されたが,70 歳を超えていたため適応外とされた.当院では70 歳以上の肝移植症例の経験もあり,レシピエントの全身状態が良好であったこと(PS2),グラフト条件も満たしていたことから,生体肝移植可能と判断し,生体肝移植術(拡大左葉グラフト)施行.術後経過は概ね良好で,術後35 日目退院となった.現在も在宅・生存中であり,非常に良好なQOLを維持している.【考察】生体肝移植は,高齢レシピエントに対してもPS が保たれている場合は,安全に施行出来る可能性が高く,良好な術後成績を得られると考える