1. Living donor liver transplantation Pre-transplant report
VS: Teng-Wei Chen
R3: Hung-Yi Yang

2. General data Donor Recipient Name:林x婷 Name:林x霞 ID: 2943676 ID: 2942325
Age: 48
Gender: F
Admission date: 2017/02/19
Operation date: 2016/12/20
Donor
Name:林x婷
ID:
Age: 23
Gender: F
Admission date: 2017/02/19
Operation date: 2016/12/20
Relationship: 母女

3. Present illness Chronic hepatitis B was noted by prenatal examination
20 years ago
Chronic hepatitis B was noted by prenatal examination
Elevated liver function by healthy examination
SBP, low leg edema, hyperbilirubemia
→ Diuretics + antibiotic + Viread
Hepatic encephalopathy, acute kidney injury
2015 Nov.
2016/9/8
2016/10/23

4. Present illnes hepatic encephalopathy re-admission
2016/10/29
hepatic encephalopathy re-admission
Liver transplant evaluation
2016/11/01

5. Past and personal history
History of systemic disease: Nil
History of major operation:
Rib fracture s/p repair.
Chondromalacia patella s/p.
Denied allergy to food or drugs
Habit of smoking: denied
Alcohol drinking:
Beer and 高粱酒 for 20 years, quit since 2016 January.
Occupation: Nil

6. Physical examination
BH: 156 cm, BW: 43 Kg, BP: 102/56 mmHg, HR: 76/min, RR:18/min, BT: 36.4 C
Conscious: alert, Mentality: intact to JOMAC, GCS: E4M6V5
Skin: jaundice, no skin rash, no ecchymosis.
HENNT: ictera sclera, anemic conjunctiva; no gum bleeding. no palpable neck nodes
Chest: no rhonchi, no decreased breathing sound.
Heart: Regular heart beats; no murmurs
Abdomen: soft and flat in shape; no tenderness; normal bowel sound.
Extremities: no pitting edema , no limitation of motion, no peripheral cyanosis.
Nervous system: no impairment of motor or sensory function

7. Serologic examinations
B/R
SMA
Tumor markers
Virology study
WBC
3,020
BUN 31
AFP
11.95
HBsAg + Hb
11.3 Cr
1.2
CA-199
14.82
HBsAb -
Plt
51,000
AST 83
HBeAg PT
12.2
ALT 56
HBeAb
PTT
28.7
T. Bil
4.6
Others
HBcAb
INR
D. Bil
1.6
PAP
38 mmHg
Anti-HCV
Alb
3.2 EF
64%
CMV IgG
NH3
137
FEV1/FVC
67%
HIV Ab/Ag
r-GT 46
HSV IgG
EBV IgG
RPR NR
Criteria
1 point
2 points
3 points
Bilirubin (mg/l)
<2
2-3
>3
Albumin (g/l)
>3.5
<2.8
INR
<1.7
>2.2
Ascites
Nil
Controlled
Poor control
Encephalopathy
Child C

8. 2016.11.02 WITHOUT CONTRAST MRI-ABDOMEN
The liver shows irregular contour with splenomegaly and moderate ascites, cirrhosis of liver with portal hypertension.

9. Tentative diagnosis
HBV and Alcohol related liver cirrhosis complicated with hepatic encephalopathy ( and ), moderate ascites, portal hypertension, splenomegaly, anemia, thrombocytopenia, hyperbilirubinemia, hypoalbuminemia and hyperammonemia. Child C (11)[MELD SCORE=15].

11. General data Donor Recipient Name:林x婷 Name:林x霞 ID: 2943676 ID: 2942325
Age: 48
Gender: F
Admission date: 2017/02/19
Operation date: 2016/12/20
Donor
Name:林x婷
ID:
Age: 23
Gender: F
Admission date: 2017/02/19
Operation date: 2016/12/20
Relationship: 母女

12. Donor Past & Personal history: Hx of systemic disease: nil
History of major operation: nil.
Hx of smoking: nil.
Hx of drinking: nil.
5. Occupation: STUDENT.
Physical examination
BH/BW: 154 cm/45 kg;
others not remarkable

13. Serologic examination
B/R
SMA
Tumor markers
Virology study
WBC
6,870
BUN 10
AFP
1.7
HBsAg - Hb
13.1 Cr
0.7
CA-199 NA
HBsAb
Plt
173,000
AST 17
CEA
HBeAg PT
10.0
ALT 8
HBeAb
PTT
26.2
T. Bil
0.5
Others
HBcAb
INR
0.9
D. Bil
0.1
Anti-HCV
Alb
4.6
CMV IgG
NH3 52
HIV Ab/Ag
r-GT
HSV IgG TC
192
EBV IgG + TG 96
RPR NR

14. Donor-recipient-match profile
Gender F
Blood type A+ O+
Body height/weight
156/43
154/45
HLA-ABC
A2,A24,B48,Bw6,Cw8
A2,A24,B62,B48,Bw6,Cw7,Cw8
HLA-DR
DR8,DR14,DR52
DR7,DR8,DR53
HLA-DQ
DQ6,DQ5
DQ2,DQ6
Kinship
Mother
Daughter

15. Liver : Spleen =1.1
說明：肝臟與脾臟比值，如比值大於1.0 ，表示正常

16. Hepatic Artery

17. Hepatic Vein

18. Portal Vein

19. Bile Duct

20. 總結 捐贈者為健康之女性，右肝捐贈 捐贈者肝臟：878公克，捐贈456公克肝臟，約其肝臟52%，保留382公克。
受贈者：最少需要之肝臟體積為其體重0.8%
此次受贈肝臟約其體重1.0%