Living donor liver transplantation

Area of Science:

• Hepatology
• Transplantation Surgery
• Organ Donation

Background:

• The scarcity of deceased donor organs drives the need for alternatives like living donor liver transplantation (LDLT).
• LDLT has evolved from an experimental procedure to an established, life-saving intervention.

Purpose of the Study:

• To review the advancements and current status of living donor liver transplantation (LDLT).
• To highlight the benefits and challenges of LDLT compared to deceased donor liver transplantation (DDLT).

Main Methods:

• Review of recent innovations in LDLT surgical techniques and patient management.
• Analysis of outcomes for LDLT, including for patients with high MELD scores and hepatocellular carcinoma.
• Assessment of psychosocial impacts on living liver donors.

Main Results:

• Innovations in understanding graft anatomy and physiology minimize complications like graft congestion and small-for-size syndrome.
• LDLT achieves comparable results to DDLT, even for patients with high Model for End-Stage Liver Disease (MELD) scores.
• Extended criteria for hepatocellular carcinoma (HCC) in LDLT show feasibility with slightly reduced survival; dual grafts overcome size limitations.

Conclusions:

• LDLT is the most effective alternative to deceased donor liver transplantation (DDLT), offering superior allograft quality and reduced waiting times.
• Benefits include reduced waiting list mortality and optimized transplantation timing.
• Ongoing evolution of LDLT continues to enhance its efficacy and application.