TRANSPLANTATION OF THE LIVER Third Edition Ronald W. Busuttil, MD, PhD William P. Longmire, Jr., Chair in Surgery Distinguished Professor and Executive Chairman UCLA Department of Surgery Chief, Division of Liver and Pancreas Transplantation David Geffen School of Medicine at UCLA Los Angeles, California Göran B.G. Klintmalm, MD, PhD Chief and Chairman Annette C. and Harold C. Simmons Transplant Institute W.W. Caruth Chair in Organ Transplant Immunology Professor of Surgery, Texas A&M College of Medicine Vice Chair, Department of Surgery Division Chief, Transplant Surgery Dallas, Texas 1600 John F. Kennedy Blvd. Ste 1800 Philadelphia, PA 19103-2899 TRANSPLANTATION OF THE LIVER, THIRD EDITION ISBN: 978-1-4557-0268-8 Copyright © 2015, 2005, 1996 by Saunders, an imprint of Elsevier Inc. 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Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods, they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence, or otherwise or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Library of Congress Cataloging-in-Publication Data Transplantation of the liver (Busuttil) Transplantation of the liver / [edited by] Ronald W. Busuttil, Göran B.G. Klintmalm. -- Third edition. p. ; cm. Includes bibliographical references and index. ISBN 978-1-4557-0268-8 (hardback : alk. paper) I. Busuttil, Ronald W., editor. II. Klintmalm, Göran B., editor. III. Title. [DNLM: 1. Liver Transplantation. 2. Liver Diseases--surgery. WI 770] RD546 617.5’5620592--dc23 2014037966 Executive Content Strategist: Michael Houston Content Development Manager: Joan Ryan Publishing Services Manager: Anne Altepeter Project Manager: Jennifer Nemec Moore Design Direction: Lou Forgione Printed in the United States of America Last digit is the print number: 9 8 7 6 5 4 3 2 1 C ontributors Kareem Abu-Elmagd, MD, PhD Lars Bäckman, MD, PhD Professor of Surgery Professor of Surgery Digestive Disease Institute Director, Transplantation Surgery Transplantation Center Uppsala University Hospital Cleveland Clinic Uppsala, Sweden Cleveland, Ohio Organ Allocation: The European Models Leukocyte Chimerism—Meaning and Consequences Talia B. Baker, MD Chul-Soo Ahn, MD, PhD Associate Professor of Surgery Professor of Surgery Northwestern University Hepatobiliary Surgery and Liver Transplantation Director, Living Donor Liver Transplant Asan Medical Center Comprehensive Transplant Center Ulsan University College of Medicine Chicago, Illinois Seoul, South Korea Minimally Invasive Living Donor Hepatectomy Dual Grafts for Transplantation William F. Balistreri, MD Reza Allamezadeh, MD Professor of Pediatrics and Medicine Clinical Instructor Director, Pediatric Liver Care Center Department of Medicine Gastroenterology, Hepatology, and Nutrition Nephrology Division Children’s Hospital Medical Center Kidney Transplant Program Cincinnati, Ohio David Geffen School of Medicine at UCLA Transplantation for Cholestatic Liver Disease Los Angeles, California in Children Renal Failure in Adults Rafael Bañares, MD Estella M. Alonso, MD Professor and Head of Medicine Professor of Pediatrics Liver Unit Northwestern University Feinberg School of Medicine Hospital General Universitario Gregorio Marañón Medical Director Faculty of Medicine Liver Transplant Program Complutense University of Madrid Chicago, Illinois Madrid, Spain General Criteria for Pediatric Transplantation Current Clinical Status of Extracorporeal Devices Maria H. Alonso, MD Angeles Baquerizo, MD, PhD Associate Professor Transplant and Hepatobiliary Surgeon Division of Pediatric General and Thoracic Surgery Scripps Center for Cell and Organ Transplantation University of Cincinnati La Jolla, California Surgical Director Current Clinical Status of Extracorporeal Devices Kidney Transplant Program Cincinnati Children’s Hospital Medical Center Lokesh Bathla, MD Cincinnati, Ohio Fellow, Section of Transplant Surgery Transplantation for Hepatic Malignancy in Children University of Nebraska Medical Center Omaha, Nebraska Nancy L. Ascher, PhD Intestinal and Multivisceral Transplantation Professor and Chair Department of Surgery William Bennet, MD, PhD Isis Distinguished Professor in Transplantation Senior Surgeon Leon Goldman, MD, Distinguished Professor in Director of Liver Transplantation Surgery Transplant Institute Division of Transplant Surgery Sahlgrenska University Hospital University of California, San Francisco Gothenburg, Sweden San Francisco, California Organ Allocation: The European Models Rejection After Transplantation v vi Contributors Marina Berenguer, MD Sherilyn Gordon Burroughs, MD University Valencia Assistant Professor of Surgery Department of Medicine Weill-Cornell Medical College Hepatology and Liver Transplantation Unit General Surgery and Organ Transplantation La Fe Hospital and CIBEREHD Center for Liver Disease and Transplantation National Network Center for Hepatology and The Methodist Hospital Gastroenterology Research Houston, Texas Hospital Universitario La Fe Donor Selection and Management Valencia, Spain Transplantation for Hepatitis C Ronald W. Busuttil, MD, PhD William P. Longmire, Jr., Chair in Surgery Gabriela A. Berlakovich, MD Distinguished Professor and Executive Chairman Associate Professor UCLA Department of Surgery Department of Surgery Chief, Division of Liver and Pancreas Transplantation Division of Transplantation David Geffen School of Medicine at UCLA Medical University of Vienna Los Angeles, California Vienna, Austria Surgical Anatomy of the Liver; Influence of Transplantation Organ Allocation: The European Models on Liver Surgery; Transplantation for Cholangiocarcinoma; Transplantation for Biliary Atresia in Children; Management Jorge A. Bezerra, MD of Portal Hypertensive Hemorrhage; Extended Criteria Professor of Pediatrics Donors; Recipient Hepatectomy and Grafting; Arterial Division of Gastroenterology, Hepatology, and Reconstruction; Portal Vein Thrombosis and Other Venous Nutrition Anomalies; Retransplantation; Situs Inversus and Polysplenia Cincinnati Children’s Hospital Medical Center Syndrome; Graft Failure; Arterial Complications After Cincinnati, Ohio Transplantation; Outcome Predictors in Transplantation; Transplantation for Cholestatic Liver Disease in Children Long-Term Functional Recovery and Quality of Life; Ischemia-Reperfusion Injury in Liver Transplantation Jacob L. Bilhartz, MD Fellow, Division of Gastroenterology Juan Carlos Caicedo, MD Department of Pediatrics Assistant Professor of Surgery University of Michigan and C.S. Mott Children’s Northwestern Memorial Hospital Hospital Northwestern University Ann Arbor, Michigan Chicago, Illinois Transition of Pediatric Patients to Adulthood Minimally Invasive Living Donor Hepatectomy Robert S. Brown, Jr., MD Andrew M. Cameron, MD Frank Cardile Professor of Medicine and Pediatrics Associate Professor (in Surgery) Department of Surgery Columbia University College of Physicians and Johns Hopkins Medical Institutions Surgeons Baltimore, Maryland Medical Director, Transplant Initiative Management of Portal Hypertensive Hemorrhage New York-Presbyterian, Morgan Stanley Children’s Hospital Jeffrey Campsen, MD Columbia University Medical Center Assistant Professor of Surgery Director, Center for Liver Disease and Division of Transplant Surgery Transplantation University of Utah Health Sciences Center New York-Presbyterian Hospital/Columbia University Salt Lake City, Utah Medical Center Transplant-Related Malignancies New York, New York Current Indications, Contraindications, Delisting Criteria, Elizabeth J. Carey, MD and Timing for Transplantation Assistant Professor of Medicine Gastroenterology and Hepatology Andrew Burroughs, MD Mayo Clinic Arizona Professor of Hepatology Scottsdale, Arizona The University of London Monitoring and Care Consultant Physician and Hepatologist Royal Free Hospital Ian C. Carmody, MD London, United Kingdom Associate Professor of Surgery Organ Allocation: The European Models Transplant Services Ochsner Medical Center New Orleans, Louisiana Treatment of Acute and Chronic Rejection Contributors vii J. Michael Cecka, MD Ana J. Coito, PhD Professor Professor of Surgery Director of Clinical Research Dumont-UCLA Transplantation Research Center UCLA Immunogenetics Center Department of Surgery Department of Pathology and Lab Medicine David Geffen School of Medicine at UCLA University of California, Los Angeles Los Angeles, California Los Angeles, California Ischemia-Reperfusion Injury in Liver Transplantation ABO, Tissue Typing, and Crossmatch Incompatibility Thomas Collins, MD See-Ching Chan, MBBS, MS, PhD Clinical Associate Professor of Surgery Professor Transplantation and Hepatobiliary Surgery Department of Surgery Director of Surgical Skills Lab University of Hong Kong Transplant Fellowship Program Director Hong Kong, China Director of Liver Transplant Outcomes of Living Donor Transplantation: The Eastern University of Iowa Perspective; Adult Living Donor Right Hepatectomy and Iowa City, Iowa Recipient Operation Donation After Cardiac or Brain Death: Regulatory and Ethical Principles Michael Charlton, MD Professor of Medicine Jeffrey S. Crippin, MD Department of Gastroenterology and Hepatology Professor of Medicine Mayo Clinic and Foundation Marilyn Bornefeld Chair in Gastrointestinal Research Rochester, Minnesota and Treatment Transplantation for Nonalcoholic Steatohepatitis Internal Medicine Washington University School of Medicine Ali Cheaito, MD St. Louis, Missouri Assistant Professor of Surgery Transplantation for Sclerosing Cholangitis David Geffen School of Medicine at UCLA Los Angeles, California David C. Cronin II, MD, PhD, MHCM Arterial Complications After Transplantation Professor Department of Surgery Pauline W. Chen, MD Medical College of Wisconsin Clinical Instructor Milwaukee, Wisconsin Department of Surgery Ethics in Living Donor Transplantation David Geffen School of Medicine at UCLA Surgeon Gabriel M. Danovitch, MD Dumont-UCLA Liver Cancer Center Professor of Medicine and Transplant Center Department of Medicine Los Angeles, California Nephrology Division Treatment of Acute and Chronic Rejection Medical Director Kidney Transplant Program Srinath Chinnakotla, MD David Geffen School of Medicine at UCLA Associate Professor Los Angeles, California Department of Surgery Renal Failure in Adults University of Minnesota Medical School Minneapolis, Minnesota Gary L. Davis, MD Graft-Versus-Host Disease Professor of Medicine Director, General and Transplant Hepatology Ruben Ciria, MD Medicine Fellow, King’s Healthcare Partners Baylor Healthcare System and Baylor University Kings College Hospital FT NHS Trust Medical Center Institute of Liver Studies Dallas, Texas London, United Kingdom Natural History of Hepatitis C; Recurrent Hepatitis C Auxiliary Transplantation After Transplantation Pierre-Alain Clavien, MD, PhD Gloria de la Rosa, MD, PhD Professor and Chairman Medical Doctor Department of Surgery Spanish National Transplant Organization Division of Visceral and Transplant Surgery Madrid, Spain University Hospital Zurich Organ Allocation: The European Models Zurich, Switzerland Principles of Liver Preservation viii Contributors Anthony J. Demetris, MD Douglas G. Farmer, MD Professor Professor of Surgery Department of Pathology Liver Transplant Surgery University of Pittsburgh Dumont-UCLA Transplant Center Pittsburgh, Pennsylvania Los Angeles, California Histopathology of Liver Transplantation; Leukocyte Situs Inversus and Polysplenia Syndrome Chimerism—Meaning and Consequences Constantino Fondevila, MD, PhD Joseph DiNorcia, MD General Surgery Assistant Professor of Surgery Hospital Clinic Division of Hepatobiliary, Pancreas, and Abdominal Barcelona, Spain Organ Transplantation Extracorporeal Perfusion for Resuscitation of Marginal Grafts Keck School of Medicine of USC Los Angeles, California John L.R. Forsythe, MBBS, MD Extended Criteria Donors Transplant Unit Consultant Transplant Surgeon John P. Duffy, MD Royal Infirmary of Edinburgh Hepatobiliary and Abdominal Transplant Surgeon Edinburgh, United Kingdom Nazih Zuhdi Transplant Institute Organ Allocation: The European Models Integris Baptist Medical Center Oklahoma City, Oklahoma Alyson N. Fox, MD Arterial Reconstruction; Long-Term Functional Recovery Assistant Professor of Medicine and Quality of Life Center for Liver Disease and Transplantation New York Presbyterian Hospital-Weill Cornell Medical Francisco A. Durazo, MD Center Associate Clinical Professor of Medicine and Surgery New York, New York Digestive and Liver Diseases Current Indications, Contraindications, Delisting Criteria, Dumont-UCLA Transplant Center and Timing for Transplantation University of California, Los Angeles Los Angeles, California Ira J. Fox, MD Unusual Indications for Transplantation Professor of Surgery University of Pittsburgh School of Medicine Bijan Eghtesad, MD Director, Center for Innovative Regenerative Therapies Staff Surgeon Children’s Hospital of Pittsburgh of UPMC and the Hepato-Pancreato-Biliary/Liver Transplant Surgery McGowan Institute for Regenerative Medicine Cleveland Clinic Pittsburgh, Pennsylvania Cleveland, Ohio Liver and Hepatocyte Xenotransplantation Leukocyte Chimerism—Meaning and Consequences; Graft-Versus-Host Disease Joel E. Frader, MD, MA A Todd Davis Professor of Academic General Pediatrics Jean C. Emond, MD Professor of Medical Humanities and Bioethics Professor of Surgery Department of Pediatrics Vice Chair and Chief of Transplantation Feinberg School of Medicine New York-Presbyterian Hospital Northwestern University Columbia University Medical Center Chicago, Illinois New York, New York Ethical Decisions in Transplantation Postoperative Care of Pediatric Transplant Recipients Emily M. Fredericks, PhD Carlos O. Esquivel, MD, PhD Associate Professor of Pediatrics Professor of Surgery and Chief Division of Child Behavioral Health Division of Abdominal Transplantation Surgery University of Michigan and C.S. Mott Children’s Hospital Stanford School of Medicine Ann Arbor, Michigan Stanford, California Transition of Pediatric Patients to Adulthood Survival and Quality of Life in Children James M. Fulmer, MD Sheung Tat Fan, MS, MD, PhD, DSc Staff Radiologist Sun C.Y. Chair Professor of Surgery Baylor University Medical Center Department of Surgery American Radiology Associates, PA The University of Hong Kong Dallas, Texas Hong Kong, China Transplantation for Primary Hepatic Malignancy; Outcomes of Living Donor Transplantation: The Eastern Transplantation for Budd-Chiari Syndrome Perspective Contributors ix John J. Fung, MD, PhD Michael D. Green, MD, MPH Chairman of the Digestive Disease Institute Professor Cleveland Clinic Pediatrics, Surgery, and Clinical and Translational Cleveland, Ohio Research Leukocyte Chimerism—Meaning and Consequences University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania Juan F. Gallegos-Orozco, MD Pretransplantation Evaluation: Infectious Disease Assistant Professor of Medicine Division of Gastroenterology, Hepatology, and Rick Harrison, MD Nutrition Medical Director University of Utah Health Sciences Center Mattel Children’s Hospital UCLA Salt Lake City, Utah Department of Pediatrics Transplant-Related Malignancies University of California, Los Angeles Los Angeles, California Juan Carlos García-Valdecasas, MD Postoperative Intensive Care Management in Children Professor of Surgery General Surgery Jeanette M. Hasse, PhD, RD, LD, FADA, CNSC Hospital Clinic Transplant Nutrition Manager Barcelona, Spain Baylor Annette C. and Charles C. Simmons Transplant Extracorporeal Perfusion for Resuscitation of Marginal Institute Grafts Baylor University Medical Center Dallas, Texas Till Gerling, MD, PhD Nutritional Aspects of Transplantation in Adults Medical Staff Eurotransplant International Foundation Nigel D. Heaton, MD Leiden, The Netherlands Professor of Transplant Surgery Organ Allocation: The European Models King’s Healthcare Partners Kings College Hospital FT NHS Trust R. Mark Ghobrial, MD Institute of Liver Studies Director, Liver Center London, United Kingdom Chief, Liver Transplantation Surgery Auxiliary Transplantation; Split Liver Transplantation Director, Immunobiology Research Center for Pediatric and Adult Recipients The Methodist Hospital System Houston, Texas Amelia J. Hessheimer, MD, PhD Donor Selection and Management Resident General Surgery Antoinette S. Gomes, MD Hospital Clinic Professor of Radiological Sciences and Medicine Barcelona, Spain Radiological Sciences Extracorporeal Perfusion for Resuscitation of Marginal David Geffen School of Medicine at UCLA Grafts Los Angeles, California Radiological Evaluation in Transplantation Jonathan R. Hiatt, MD Professor of Surgery Stevan A. Gonzalez, MD Vice Dean for Faculty Division of Hepatology Vice Chair for Education Department of Medicine Surgery Annette C. and Harold C. Simmons Transplant David Geffen School of Medicine at UCLA Institute Los Angeles, California Baylor All Saints Medical Center Influence of Transplantation on Liver Surgery Dallas, Texas Natural History of Hepatitis C Curtis D. Holt, Pharm D Clinical Professor Elisa J. Gordon, PhD, MPH Department of Surgery Research Associate Professor Division of Liver and Pancreas Transplantation Comprehensive Transplant Center David Geffen School of Medicine at UCLA Northwestern University Feinberg School of Los Angeles, California Medicine Infections After Transplantation Chicago, Illinois Ethical Decisions in Transplantation x Contributors Johnny C. Hong, MD Fady M. Kaldas, MD Associate Professor of Surgery Assistant Professor of Surgery The Mark B. Adams Chair in Surgery, Hepatobiliary Division of Liver and Pancreas Transplantation Surgery, and Organ Transplantation Department of Surgery Chief, Division of Transplant Surgery David Geffen School of Medicine at UCLA Department of Surgery Los Angeles, California Medical College of Wisconsin Extended Criteria Donors Director, Solid Organ Transplantation Joint Program at Medical College of Wisconsin-Froedtert Health- Igal Kam, MD Children’s Hospital of Wisconsin-BloodCenter of Professor of Surgery Wisconsin Division of Transplant Surgery Milwaukee, Wisconsin University of Colorado, Denver Transplantation for Cholangiocarcinoma; Outcome Aurora, Colorado Predictors in Transplantation; Ischemia-Reperfusion Injury Living Donor Transplantation: Evaluation and Selection in Liver Transplantation in Adults Abhinav Humar, MD Burnett “Beau” S. Kelly, Jr., MD, MBA Professor of Surgery Assistant Professor Department of Surgery Surgery University of Pittsburgh School of Medicine Vanderbilt University Pittsburgh, Pennsylvania Nashville, Tennessee Split Liver Transplantation for Two Adult Recipients Donor Selection and Management Samar H. Ibrahim, MD Vandana Khungar, MD Gastroenterology, Hepatology, and Nutrition Fellow in Transplant Hepatology Children’s Hospital Medical Center Division of Digestive and Liver Diseases Cincinnati, Ohio Columbia University College of Physicians and Transplantation for Cholestatic Liver Disease in Children Surgeon Center for Liver Disease and Transplantation Toru Ikegami, MD New York Presbyterian Hospital-Weill Cornell Medical Assistant Professor Center Department of Surgery and Science New York, New York Graduate School of Medical Sciences Current Indications, Contraindications, Delisting Criteria, Kyushu University and Timing for Transplantation Fukuoka, Japan Small-for-Size Syndrome Khalid Khwaja, MD Senior Staff Surgeon Mohamad H. Imam, MD Lahey Clinic Medical Center Department of Gastroenterology and Hepatology Burlington, Massachusetts Mayo Clinic Organ Allocation: The U.S. Model Rochester, Minnesota Transplantation for Primary Biliary Cirrhosis Kevin King, RN, BSN, CCTC Adult Post–Liver Transplant Coordinator Yukihiro Inomata, MD, PhD Division of Liver and Pancreas Transplant Professor and Chairman Ronald Reagan UCLA Medical Center Department of Transplantation and Pediatric Surgery Los Angeles, California Kumamoto University Role of the Posttransplant Clinical Nurse Coordinator Kumamoto, Japan Living Donor Transplantation in Children Milan Kinkhabwala, MD Professor of Surgery Sally E. Jensen, PhD Chief, Division of Transplantation Research Assistant Professor Director, Abdominal Transplantation Medical Social Sciences Montefiore Medical Center Northwestern University Feinberg School of Medicine Albert Einstein College of Medicine Chicago, Illinois New York, New York Ethical Decisions in Transplantation Surgical Anatomy of the Liver Sheila Jowsey, MD Assistant Professor of Psychiatry Psychiatry and Psychology Mayo Clinic Rochester, Minnesota Psychiatric Assessment of Transplant Candidates