Domino liver transplantation: risks and benefits

Area of Science:

• Hepatology
• Transplant Surgery
• Genetics

Background:

• Domino liver transplantation involves a recipient donating their liver to another patient.
• Familial amyloidotic polyneuropathy (FAP) livers are the most common source for domino transplants.
• FAP is an inherited disorder that may not manifest clinically in carriers.

Purpose of the Study:

• To evaluate the safety and efficacy of domino liver transplantation using FAP livers.
• To assess the long-term outcomes for domino liver recipients.
• To explore the potential of domino transplantation in mitigating organ shortages.

Main Methods:

• Review of data from the Familial Amyloidotic Polyneuropathy World Transplant Registry (FAPWTR).
• Analysis of patient selection criteria for domino liver transplantation.
• Evaluation of post-transplant survival rates and complication development.

Main Results:

• Over 500 FAP livers have been used in domino transplantation.
• Only 2 FAP liver donors developed symptoms post-donation.
• Domino recipients with nonmalignant indications demonstrate excellent long-term survival.

Conclusions:

• Domino liver transplantation using FAP livers is a safe and effective strategy.
• Careful recipient selection is crucial for successful outcomes.
• This approach significantly alleviates organ scarcity and reduces waiting times for liver transplantation.