6th Studium Generale International Faculty of Medicine UI: “Liver Transplantation in Indonesia-Indonesia First Adult Living Donor Liver Transplantation in Cipto Mangunkusumo Hospital”
Dr. dr. Toar J. M Lalisang, SpB(K)BD, Head of Surgery Departement, Cipto Mangunkusumo Hospital-Universitas Indonesia
Rino A. Gani, MD, Ph.D, Chairman of Indonesian Association for The Study of The Liver, Jakarta
The 6th studium generale international was held by Faculty of Medicine, Universitas Indonesia via video conference at Jakarta Distance Learning Center (JDLC) UI on November 28, 2014 from 09:00-11:00 am.
The session discussed about “Liver Transplantation in Indonesia-Indonesia First Adult Living Donor Liver Transplantation in Cipto Mangunkusumo Hospital. This two hours session is recorded because there are no participants who able to join this session. Discussion focused on indications and contra indication of liver transplant recipes and how to preparing liver transplant candidate.
Nowadays, the liver transplantation becomes the standard treatment of choice in pediatric and adults with end liver diseases.
Method: We report result of living donor liver transplantation (LT) in Cipto Mangunkusumo Hospital, Jakarta Indonesia. There were seven living donor LT were carried out in 4 pediatric (male) and 2 adults (male). The program commenced in December 2010, the team was supported by first affiliated Hospital Zhejiang University LT team, Hangzhou China. In the last 3 pediatric cases, the team was supported by NUSH Singapore LT team. Management of LT in adult cases was the first LT done in Indonesia. Indication of LT for pediatric includes biliary atresia (2) and autoimmune liver disease (2), whileas in adult is HCC and hepatitis B. All donors were genetically related and there was no operative complication found; as they live healthy back to their routines and works following 2 weeks hospitalized. There were also no post–operative mortality, all the children. The first adult case survived with a good quality of life, but the other one died a year later due to rejection. Prolonged ascetic and hyperspleenism were noted as the most complication, which were successfully managed, conservatively. All the pediatric recipients received the left lateral lobe from adult donors, and the adult received adult liver segment 5,6,7,8 with preservation of the medial hepatic vein. The graft to recipient ratio was 0.9% and 1%.
Conclusion: LDLT can be carried out with a good result in our hospital and more adult cases are required to pass the learning curve. To build an excellent liver transplantation center in Indonesia, the international collaborative is needed.