Living donor transplant: wider selection criteria

Trends in Adult-to-Adult Living Donor Liver Transplant Organ Donation: The Johns Hopkins Experience

“…10 The total transplant rate of 11% in our center, however, is slightly lower than reported elsewhere. [11][12][13][14][15][16][17] Again, this fact emphasizes the unequal distribution of available compatible living donors in our center, as in other centers, and regional discrepancies in deceased liver waiting lists. The vast majority of patients with a discernible mass lesion consistent with hepatocellular carcinoma received deceased donor liver transplants in a relatively short time on the basis of MELD exception rules, regardless of living donor availability.…”

“…As shown in Table 4, only 36% of the denials were due to the donor not being medically acceptable, with half (50%) of the denials caused by either a deterioration in the recipient condition, including death, or the recipient receiving a deceased liver graft. This underlines the highly fluid condition of these potential recipients, especially in regions with longer waiting times for deceased donor liver transplants, [11][12][13][14][15][16] requiring the implementation of faster than current processes for donor evaluation that may finish early enough to be beneficial for the majority of the recipients who cannot benefit currently from the AALDLT (see Figure). tion was adult progeny, followed by friends and inlaws (unrelated), followed by siblings.…”