Reduced Mortality with Right-Lobe Living Donor Compared to Deceased-Donor Liver Transplantation When Analyzed from the Time of Listing

Abstract

Right lobe living donor liver transplantation (RLDLT)is not yet a fully accepted therapy for patients with end-stage liver failure in the Western hemisphere because of concerns about donor safety and inferior recipient outcomes. An outcome analysis from the time of listing for all adult patients who were listed for liver transplantation (LT) at our center was performed.

Comparison of Right Lobe Donor Hepatectomy with Elective Right Hepatectomy for Other Causes in New York

“…Comprehensive documentation of complications and long-term follow-up will continue to be required to define donor risk and to advance the field. Acceptance of living donor liver transplantation in the scientific community and public rests on an assurance that this procedure is safe and performed by experienced individuals and teams [3,6,[21][22][23][24]. One way to gain acceptance and understand pitfalls and complications with RLDH is through a live donor registry.…”

“…Experience with elective liver resections have shown that 75% of a normal liver can be resected without causing severe liver dysfunction as the remaining 25% is adequate for the immediate needs of the patient and will undergo rapid hypertrophy [2]. A benefit in overall survival from the time of listing with LDLT compared to deceased donor recipients has been shown previously [3]. A multicenter study described improved graft survival and recipient outcomes with increasing center experience [4].…”

Hot topics in liver transplantation: Organ allocation – extended criteria donor – living donor liver transplantation

“…Reduced waiting time is the big advantage of LDLT and this obviously could also impact on patient survival. This was addressed in a recent study by Shah et al that analyzed the outcome of LDLT from the time of listing and not from the time of transplant [85]. In their large study with 144 LDLT and 350 DDLT recipients, they could show that LDLT recipients had a significant survival advantage over DDLT after 1 year (90% 1-year survival compared to 80%).…”

Requiem for a champion? Living donor liver transplantation

“…Is the data from other centers misleading because of less reported morbidity due to different and not comparable classification systems? While many available studies provided a focus on donor morbidity, the data in terms of recipient outcome are mostly incomplete ( [6][7][8][9][10][11][12][13][14], Table 1). Rarely standardized grading systems are applied and only limited series report on complication development over time.…”