"No-donor" liver transplantation

Area of Science:

• Hepatology
• Transplantation Surgery
• Organ Donation

Background:

• Liver transplantation is severely limited by a persistent shortage of donor organs.
• Expanding donor criteria and maximizing graft utilization are crucial for addressing this shortage.

Purpose of the Study:

• To review the clinical practice and experiences of "no-donor" liver transplantation, particularly focusing on Chinese transplant teams.
• To highlight advancements and novel donor indications in this field.

Main Methods:

• Review of clinical practices and outcomes of "no-donor" liver transplantation.
• Analysis of domino liver transplantation, introduced in 1995 and implemented in China in 2013.
• Examination of cross-auxiliary domino liver transplantation and its expansion of the graft pool.

Main Results:

• Domino liver transplantation has been successfully implemented, with novel donor indications emerging.
• The first "rigorously without donation" liver transplantation was performed in 2018.
• Cross-auxiliary domino liver transplantation further expands the potential donor graft pool.

Conclusions:

• "No-donor" liver transplantation strategies, including domino and cross-auxiliary domino procedures, offer a viable solution to organ scarcity.
• Successful implementation requires close collaboration among researchers, surgeons, physicians, organ procurement organizations, and ethical committees.
• Continued innovation and cooperation are essential for the advancement and widespread adoption of these techniques.