Outcomes of 385 Adult-to-Adult Living Donor Liver Transplant Recipients

Olthoff, Kim M.; Merion, Robert M.; Ghobrial, Rafik M.; Abécassis, Michaël; Fair, Jeffrey H.; Fisher, Robert A.; Freise, Chris E.; Kam, Igal; Pruett, Timothy L.; Everhart, James E.; Hulbert-Shearon, Tempie E.; Gillespie, Brenda W.; Emond, Jean C.; Miller, Charles M.; Pollak, Raymond; Huddleston, Charles B.; Ascher, Nancy L.; Shaw, Byers W.; Mentzer, Robert M.

doi:10.1097/01.sla.0000179646.37145.ef

Cited by 321 publications

(114 citation statements)

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“…This observation is in contrast to the corresponding A2ALL analyses of recipient outcomes and its predictors, in which a "learning curve" was identified and recipient outcomes improved after center experience with more than 20 adult-to-adult LDLT procedures. 28 The lack of a significant association between center experience and donor complications may indicate that surgical experience with hepatic resections outside the transplantation setting provides adequate training for the adult donor operation in LDLT but could also represent a type II error. Larger numbers of cases with more intensive follow-up of donors in the A2ALL prospective cohort study may yet identify other important predictors of complications that could be eliminated or ameliorated.…”

Section: Discussionmentioning

confidence: 99%

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Donor Morbidity After Living Donation for Liver Transplantation

et al. 2008

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confidence: 99%

“…Each adult-to-adult LDLT was then categorized as having occurred when the center was less experienced or more experienced based on case numbers ≤20 or >20, respectively. 28 …”

Section: Definitions and Data Collectionmentioning

confidence: 99%

Donor Morbidity After Living Donation for Liver Transplantation

et al. 2008

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“…A wide range of living donor complication rates are reported in the literature, with an estimated risk of mortality and morbidity after right hepatectomies for living related liver transplantation (RHLD) of 0.4% and 35%, respectively. Overall, the complication rates range from 0% to 67%, with an overall crude complication rate of 31% [31,32] . The literature has reported 11 deaths, and 2 liver transplants in donors who have undergone RHLD.…”

Section: Donor Outcomesmentioning

confidence: 99%

Liver resections for liver transplantations

Gruttadauria¹,

Francesco²,

Pagano³

et al. 2010

WJGS

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“…4 Between January 1, 1998 and February 28, 2003, these centers evaluated 819 potential LDLT recipients, for whom 1011 donor candidates were evaluated. Two subsets of these potential donors have been previously reported in single-center evaluations of this topic.…”

Section: Study Subjectsmentioning

confidence: 99%

Outcomes of Donor Evaluation in Adult-to-Adult Living Donor Liver Transplantation

Makar¹

2008

Yearbook of Gastroenterology

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The purpose of donor evaluation for adult-to-adult living donor liver transplantation (LDLT) is to discover medical conditions that could increase the donor postoperative risk of complications and to determine whether the donor can yield a suitable graft for the recipient. We report the outcomes of LDLT donor candidates evaluated in a large multicenter study of LDLT. The records of all donor candidates and their respective recipients between 1998 and 2003 were reviewed as part of the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL). The outcomes of the evaluation were recorded along with demographic data on the donors and recipients. Of the 1011 donor candidates evaluated, 405 (40%) were accepted for donation. The donor characteristics associated with acceptance (P < 0.05) were younger age, lower body mass index, and biological or spousal relationship to the recipient. Recipient characteristics associated with donor acceptance were younger age, lower Model for End-stage Liver Disease score, and shorter time from listing to first donor evaluation. Other predictors of donor acceptance included earlier year of evaluation and transplant center. This is publication number 5 of the Adult-to-Adult Living Donor Liver Transplantation Cohort Study.Potential conflict of interest: Dr. Trotter is a consultant for and received grants from Novartis. He is on the speakers' bureau of and received grants from Roche. He is also on the speakers' bureau of Astellas. He also received grants from Cellzdirect, Aventis-Sanofi, and Abbott. Conclusion-Both donor and recipient features appear to affect acceptance for LDLT. These findings may aid the donor evaluation process and allow an objective assessment of the likelihood of donor candidate acceptance. NIH Public AccessDonor evaluation is one of the most important aspects of adult-to-adult living donor liver transplantation (LDLT). 1-3 The evaluation process is designed to reveal any condition that may increase the risk of complications for the donor. In addition, the transplant team should determine whether the donor will yield a suitable graft for the recipient. The evaluation process typically proceeds in a stepwise fashion so that unsuitable donors can be identified as early as possible. Acceptance of donors by the evaluating team implies that they have met all relevant medical, surgical, psychosocial, and informed consent criteria necessary to proceed with donor right hepatic lobectomy.The Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL) is a multicenter project funded by the National Institutes of Health to evaluate the outcomes of donors and recipients evaluated for and undergoing this procedure. Although designed with both retrospective and prospective phases, the data presented in this report are derived from the retrospective phase of A2ALL. There were three major goals of the analysis: (1) to describe the characteristics and acceptance rate of donor candidates; (2) to examine the evolution of donor selection over time; and (...

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Outcomes of 385 Adult-to-Adult Living Donor Liver Transplant Recipients

Abstract: This multicenter A2ALL experience provides evidence that ALDLT is a viable option for liver replacement. Older recipient age and prolonged cold ischemia time increase the risk of graft failure. Outcomes improve with increasing center experience.

Cited by 321 publications

References 59 publications

Donor Morbidity After Living Donation for Liver Transplantation

Donor Morbidity After Living Donation for Liver Transplantation

Liver resections for liver transplantations

Outcomes of Donor Evaluation in Adult-to-Adult Living Donor Liver Transplantation

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