Liver Living Donation for Cancer Patients: Benefits, Risks, Justification

Nadalin, Silvio; Genedy, Lara; Königsrainer, Alfred

doi:10.1007/978-3-030-63749-1_10

Cited by 2 publications

(2 citation statements)

References 73 publications

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“…It is the transplant team’s job to analyse whether the specific recipient's benefit justifies the specific donor's risk for a particular oncologic indication and protect donors from donation if the potential harm outweighs the expected benefit. 204 , 205 Currently, no consensus exists about what constitutes acceptable recurrence and donor risks, and ethical considerations may differ in different societal contexts. 195 , 205 …”

Section: Ethical and Technical Aspects Of Transplant Oncologymentioning

confidence: 99%

Transplant oncology – Current indications and strategies to advance the field

Krendl,

Bellotti,

Sapisochin

et al. 2024

JHEP Reports

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Section: Ethical and Technical Aspects Of Transplant Oncologymentioning

confidence: 99%

Transplant oncology – Current indications and strategies to advance the field

Krendl,

Bellotti,

Sapisochin

et al. 2024

JHEP Reports

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“…The role of LDLT is expected to be also relevant in terms of intention-to-treat survival benefit in the setting of wellselected secondary, colorectal, and neuroendocrine tumors (14,(24)(25)(26)(27)(28)(29).…”

mentioning

confidence: 99%

A Western World Perspective of Survival Benefit of Living Donor Liver Transplantation: A Commentary to the Article by Jackson et al. Published in JAMA Surgery

Lai

Lerut

2022

Transpl Int

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Liver transplantation is the best treatment for several liver diseases causing acute or chronic hepatic failure, primary and secondary hepatobiliary tumors, and liver-based inborn metabolic errors (1). Unfortunately, many patients die on the list or are too sick and drop out, thus losing the opportunity to be transplanted (2). Consequently, every effort needs to be made to overcome the allograft shortage.Recently, the deceased-donor pool has been substantially extended using technical variants like split and domino transplants (3-5), more aged or cardiac death donors, and machine perfusion technology (6, 7). However, all these measures remain insufficient to cover the actual needs.Living donor liver transplantation (LDLT) represents the best, although ethically more complex, way to overcome allograft shortage. Recently, a study from the US by Jackson et al. published in JAMA Surgery has added relevance to the role of LDLT also in a Western setting (8).LDLT has many significant advantages. First, LDLT allows transplanting a given patient without harming the patients inscribed on the waiting list (9). Secondly, LDLT consents to offer an "ideal" graft with minimal ischemia time (10). Thirdly, this procedure allows for an electively and timely transplant of a given recipient, therefore offering the best economic solution to cure given liver disease. All these advantages must be counterbalanced with the ethical justification of the procedure and the potential donor risk for morbidity and mortality (11,12).Live donation has flourished in Asian centers, mainly due to the historical shortage of deceased donor liver transplantation (DDLT) cases ( 13). In sharp contrast to the Eastern world, LDLT still represents a (too) limited activity in the Western world based on the challenging balance between the weight of the risks linked to the donor hepatectomy and the benefits to the recipient (14,15). This Western hesitation related to LDLT has been "fed" by teams embarked on such programs without having gathered enough experience in transplantation and advanced liver surgery. The too high morbidity rates and some donor mortalities hampered the evolution of LDLT in the Western world, leading in turn to the absence of adequately numbered studies allowing to identify the patient

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Liver Living Donation for Cancer Patients: Benefits, Risks, Justification

Cited by 2 publications

References 73 publications

Transplant oncology – Current indications and strategies to advance the field

Transplant oncology – Current indications and strategies to advance the field

A Western World Perspective of Survival Benefit of Living Donor Liver Transplantation: A Commentary to the Article by Jackson et al. Published in JAMA Surgery

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