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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 cirrho...sis 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．show more
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