Adult to adult living donor liver transplantation: Review

Abstract

Since the first liver transplantation performed by Starzl in 1963, this has become the standard therapy for end-stage chronic liver disease and acute hepatic failure and the therapy of choice in selected cases of hepatic malignancy. The clinical outcome in patient and graft survival has increased continuously due to the optimization of intra- and postoperative management, new immunosuppressant drugs and improved organ procurement. The shortage of cadaveric donor organs has led to the development of new surgical techniques and living donor transplantation. Adult to adult living donor transplantation has been evolving over the past decade. Living-donation of the left lobe of the liver has become highly successful in pediatric transplantation whereas some transplant centers perform adult-to-adult right lobe transplantation. Advantages of living donor liver transplantation (LDLT) include thorough donor screening, optimization of timing for transplantation, minimal cold ischemia time, and potentially decreased cost. Careful evaluation and patient selection results in good patient and graft survival after transplantation. However, LDLT poses a risk to the donor.