Our Living Donor Protocol for Liver Transplant: A SingleCenter Experience

The shortage of deceased donor organs is a limiting factor in transplant. The growing discrepancy between the wait list demand versus the supply of deceased donor organs has created an incentive for consideration of living donor liver transplant as an alternative. Here, we describe our evaluation process and donor complications.

Since 1988, we have performed 659 (449 living donor and 210 deceased donor) liver transplants. The most important evaluation criteria is the relationship between donor and recipient, and we require thatthe donor must be related to the recipient. The evaluation protocol has 5 stages. Donor complications were defined as simple, moderate, and severe.

We retrospectively investigated data for 1387 candidates, and 938 (67.7%) were rejected; subsequently, 449 living donor liver transplants were performed. There were no complications in 398 of the donors (88.7%). Total complication rate was 11.3%. Simple complications were seen in 31 patients (6.9%). Moderate complications were seen in 19 patients (4.2%). We had only 1 severe complication, ie, organ failure from unspecified liver necrosis, which resulted in death.

The relationship between donor and recipient and donor safety should be the primary focus for living donor liver transplant. Donor selection should be made carefully to minimize complications and provide adequately functional grafts.