Living donor versus deceased donor liver transplantation: a surgeon-matched comparison of recipient morbidity and outcomes

Abstract

Informed consent for living donor liver transplantation (LDLT) requires that patients are provided with accurate information on the relative benefits and risks of this procedure compared with deceased donor liver transplantation (DDLT). There is strong evidence to suggest that LDLT facilitates timely transplantation to patients; however, information on the relative morbidity and death risks after LDLT as compared with DDLT is limited. A matched cohort comparison was performed matching recipients for age, MELD, date of transplant, gender, primary diagnosis, and recipient surgeon. A total of 145 LDLT were matched with 145 DDLT. LDLT had a higher overall rate of perioperative surgical complications (P = 0.009). Most of this difference was caused by a higher rate of biliary complications. However, the complications that occurred in the DDLT group tended to be more serious (P = 0.037), and these complications were strongly associated with graft loss in multivariate analysis. The 3-and 5-year graft and patient survivals were similar. In conclusion, DDLT and LDLT have different complication profiles, but comparable hospital stays and survival rates. In areas of deceased donor organ shortages, LDLT offers an excellent alternative to DDLT because it facilitates access to a liver transplant without compromising short-or medium-term recipient outcomes.

Living Donor Liver Transplant Versus Cadaveric Liver Transplant Survival in Relation to Model for End-Stage Liver Disease Score

“…In agreement with our data, a recent systematic review concluded that the use of pre-transplant MELD does not serve as a reliable predictor of posttransplantation survival [12]. In another paper, 145 LDLT were matched 1:1 with DDLT, and there was no difference in survival rates between the groups; they had 8 patients in each arm with MELD>25 [13].…”

Live Donor Liver Transplantation: A Valid Alternative for Critically Ill Patients Suffering From Acute Liver Failure

“…Potential donors and recipients are advised of the morbidity and mortality rate based on the program experience (16,17). Also, they are informed that, at our institution, recipients overall survival rate for LDLT and DDLT is similar (18). Of note, all recipients suffering from ALF remain active on the deceased donor liver transplant waiting list until start of the live donor surgery.…”

Clinical Impacts of Donor Types of Living vs. Deceased Donors: Predictors of One-Year Mortality in Patients with Liver Transplantation

“…However, the studies about the clinical manifestations, complications, and mortality based on the type of donor reported many different results. Some studies reported similar biliary complications between LDLT and deceased donor liver transplantation (DDLT) (34). Quintini et al (5) found that LDLT is safe and, in select cases, offers advantages over DDLT.…”