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Updated: Jul 6, 2026
12:49
Porcine Liver Transplantation Without Veno-Venous Bypass As an Extended Criteria Donor Model
Published on: August 17, 2022
Living donor liver transplantation: Eastern experiences
1Department of Transplantation and Immunology, Kyoto University Hospital, Kyoto, Japan. koichi@kuhp.kyoto-u.ac.jp
Summary
Living donor liver transplantation (LDLT) has become crucial in East Asia due to donor shortages. Advances have made LDLT safe and expanded its use, offering vital treatment for end-stage liver disease.
Area of Science:
- Hepatology
- Transplantation Surgery
- Surgical Innovation
Background:
- Severe shortage of cadaveric liver grafts, particularly in East Asia, spurred rapid development of living donor liver transplantation (LDLT) in the 1990s.
- Cultural and logistical factors limit brain-death donor availability in East Asia, making LDLT a critical alternative for end-stage liver disease treatment.
- LDLT techniques have advanced significantly, enabling successful transplantation with improved outcomes and no reported donor mortality in East Asian countries.
Purpose of the Study:
- To review the evolution and current status of living donor liver transplantation (LDLT) in East Asia.
- To highlight the unique challenges and adaptations of LDLT in regions with limited cadaveric donor availability.
- To compare East Asian LDLT practices with those in Western countries, focusing on indications, graft size, and ABO compatibility.
Main Methods:
- Review of cumulative data and surgical advancements in LDLT from East Asian countries.
- Comparative analysis of LDLT indications and outcomes between East Asian and Western centers.
- Examination of specific technical considerations, including right lobe grafts and ABO blood type matching.
Main Results:
- Over 2000 LDLTs performed in East Asia with no donor mortality, demonstrating the safety and efficacy of the procedure.
- Expansion of LDLT indications from pediatric to adult recipients, facilitated by the use of right lobe grafts.
- Significant differences observed in LDLT practices compared to Western countries, particularly regarding graft selection and ABO compatibility.
Conclusions:
- Living donor liver transplantation is a well-established and safe procedure in East Asia, crucial for managing end-stage liver disease.
- Adaptations in LDLT techniques and indications have broadened its application, offering a viable solution where cadaveric donors are scarce.
- Understanding regional differences in LDLT is essential for advancing liver transplantation globally and optimizing patient outcomes.
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