1932

Abstract

Adult-to-adult living donor liver transplantation (LDLT) was introduced in response to the shortage of deceased donor liver grafts. The number of adult living donor transplants is increasing due to improved outcomes and increasing need. Advantages of LDLT include optimization of the timing of transplant, better organ quality, and lower rates of recipient mortality compared to staying on the wait list for deceased donor liver transplant. Donor safety remains the major focus when considering LDLT. Recent advancements have supported the increased use of LDLT to help decrease wait list death and improve long-term survival of transplant recipients.

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2019-01-27
2024-04-16
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Literature Cited

  1. 1.  Broelsch CE, Burdelski M, Rogiers X et al. 1994. Living donor for liver transplantation. Hepatology 20:7S49–55
    [Google Scholar]
  2. 2.  Clavien P-A, Oberkofler C, Raptis D et al. 2010. What is critical for liver surgery and partial liver transplantation: size or quality?. Hepatology 52:715–29
    [Google Scholar]
  3. 3.  Wachs ME, Bak TE, Karrer FM et al. 1998. Adult living donor liver transplantation using a right hepatic lobe. Transplantation 66:101313–16
    [Google Scholar]
  4. 4.  Malagó M, Rogiers X, Broelsch CE 1995. Reduced-size hepatic allografts. Annu. Rev. Med. 46:507–12
    [Google Scholar]
  5. 5.  Bismuth H, Houssin D 1984. Reduced-sized orthotopic liver graft in hepatic transplantation in children. Surgery 95:3367–70
    [Google Scholar]
  6. 6.  Broelsch CE, Emond JC, Whitington PF et al. 1990. Application of reduced-size liver transplants as split grafts, auxiliary orthotopic grafts, and living related segmental transplants. Ann. Surg. 212:3368–75 discuss 375–77
    [Google Scholar]
  7. 7.  Bismuth H, Morino M, Castaing D et al. 1989. Emergency orthotopic liver transplantation in two patients using one donor liver. Br. J. Surg. 76:7722–24
    [Google Scholar]
  8. 8.  Emond JC, Renz JF, Ferrell LD et al. 1996. Functional analysis of grafts from living donors. Implications for the treatment of older recipients. Ann. Surg. 224:4544–52 discuss 552–44
    [Google Scholar]
  9. 9.  Dahm F, Georgiev P, Clavien PA 2005. Small-for-size syndrome after partial liver transplantation: definition, mechanisms of disease and clinical implications. Am. J. Transpl. 5:112605–10
    [Google Scholar]
  10. 10.  Yamaoka Y, Washida M, Honda K et al. 1994. Liver transplantation using a right lobe graft from a living related donor. Transplantation 57:71127–30
    [Google Scholar]
  11. 11.  Lo CM, Fan ST, Liu CL et al. 1997. Extending the limit on the size of adult recipient in living donor liver transplantation using extended right lobe graft. Transplantation 63:101524–28
    [Google Scholar]
  12. 12.  Marcos A, Ham JM, Fisher RA et al. 2000. Single-center analysis of the first 40 adult-to-adult living donor liver transplants using the right lobe. Liver Transpl 6:3296–301
    [Google Scholar]
  13. 13.  Brown RS 2008. Live donors in liver transplantation. Gastroenterology 134:61802–13
    [Google Scholar]
  14. 14.  Olthoff KM, Merion RM, Ghobrial RM et al. 2005. Outcomes of 385 adult-to-adult living donor liver transplant recipients: a report from the A2ALL Consortium. Ann. Surg. 242:3314–25
    [Google Scholar]
  15. 15.  Olthoff KM, Abecassis MM, Emond JC et al. 2011. Outcomes of adult living donor liver transplantation: comparison of the Adult-to-Adult Living Donor Liver Transplantation Cohort Study and the national experience. Liver Transpl 17:7789–97
    [Google Scholar]
  16. 16.  Abt PL, Mange KC, Olthoff KM et al. 2004. Allograft survival following adult-to-adult living donor liver transplantation. Am. J. Transpl. 4:81302–7
    [Google Scholar]
  17. 17.  Brown RS, Russo MW, Lai M et al. 2003. A survey of liver transplantation from living adult donors in the United States. N. Engl. J. Med. 348:9818–25
    [Google Scholar]
  18. 18.  Berg CL, Gillespie BW, Merion RM et al. 2007. Improvement in survival associated with adult-to-adult living donor liver transplantation. Gastroenterology 133:61806–13
    [Google Scholar]
  19. 19.  Maluf DG, Stravitz RT, Cotterell AH et al. 2005. Adult living donor versus deceased donor liver transplantation: a 6-year single center experience. Am. J. Transpl. 5:1149–56
    [Google Scholar]
  20. 20.  Pomposelli JJ, Verbesey J, Simpson MA et al. 2006. Improved survival after live donor adult liver transplantation (LDALT) using right lobe grafts: program experience and lessons learned. Am. J. Transpl. 6:3589–98
    [Google Scholar]
  21. 21.  Shah SA, Levy GA, Greig PD et al. 2007. Reduced mortality with right-lobe living donor compared to deceased-donor liver transplantation when analyzed from the time of listing. Am. J. Transpl. 7:4998–1002
    [Google Scholar]
  22. 22.  Liu CL, Fan ST, Lo CM et al. 2006. Operative outcomes of adult-to-adult right lobe live donor liver transplantation: a comparative study with cadaveric whole-graft liver transplantation in a single center. Ann. Surg. 243:3404–10
    [Google Scholar]
  23. 23.  Olthoff KM, Smith AR, Abecassis M et al. 2015. Defining long-term outcomes with living donor liver transplantation in North America. Ann. Surg. 262:3465–75
    [Google Scholar]
  24. 24.  Goldberg DS, French B, Abt PL et al. 2014. Superior survival using living donors and donor-recipient matching using a novel living donor risk index. Hepatology 60:51717–26
    [Google Scholar]
  25. 25.  Wan P, Yu X, Xia Q 2014. Operative outcomes of adult living donor liver transplantation and deceased donor liver transplantation: a systematic review and meta-analysis. Liver Transpl 20:4425–36
    [Google Scholar]
  26. 26.  Samstein B, Smith AR, Freise CE et al. 2016. Complications and their resolution in recipients of deceased and living donor liver transplants: findings from the A2ALL Cohort Study. Am. J. Transpl. 16:2594–602
    [Google Scholar]
  27. 27.  Freise CE, Gillespie BW, Koffron AJ et al. 2008. Recipient morbidity after living and deceased donor liver transplantation: findings from the A2ALL Retrospective Cohort Study. Am. J. Transpl. 8:122569–79
    [Google Scholar]
  28. 28.  Reichman TW, Katchman H, Tanaka T et al. 2013. Living donor versus deceased donor liver transplantation: a surgeon-matched comparison of recipient morbidity and outcomes. Transpl. Int. 26:8780–87
    [Google Scholar]
  29. 29.  El-Meteini M, Hamza A, Abdalaal A et al. 2010. Biliary complications including single-donor mortality: experience of 207 adult-to-adult living donor liver transplantations with right liver grafts. HPB 12:2109–14
    [Google Scholar]
  30. 30.  Soin AS, Kumaran V, Rastogi AN et al. 2010. Evolution of a reliable biliary reconstructive technique in 400 consecutive living donor liver transplants. J. Am. Coll. Surg. 211:124–32
    [Google Scholar]
  31. 31.  Marcos A 2000. Right-lobe living donor liver transplantation: a review. Liver Transpl 6:13–20
    [Google Scholar]
  32. 32.  Pomposelli JJ, Goodrich NP, Emond JC et al. 2016. Patterns of early allograft dysfunction in adult live donor liver transplantation: the A2ALL experience. Transplantation 100:71490–99
    [Google Scholar]
  33. 33.  Olthoff KM, Emond JC, Shearon TH et al. 2015. Liver regeneration after living donor transplantation: Adult-To-Adult Living Donor Liver Transplantation Cohort Study. Liver Transpl 21:179–88
    [Google Scholar]
  34. 34.  Northup PG, Abecassis MM, Englesbe MJ et al. 2009. Addition of adult-to-adult living donation to liver transplant programs improves survival but at an increased cost. Liver Transpl 15:2148–62
    [Google Scholar]
  35. 35.  Merion RM, Shearon TH, Berg CL et al. 2010. Hospitalization rates before and after adult-to-adult living donor or deceased donor liver transplantation. Ann. Surg. 251:3542–49
    [Google Scholar]
  36. 36.  Barbas AS, Goldaracena N, Dib MJ et al. 2017. Early intervention with live donor liver transplantation reduces resource utilization in NASH: the Toronto experience. Transpl. Direct 3:6e158
    [Google Scholar]
  37. 37.  Valentín-Gamazo C, Malagó M, Karliova M et al. 2004. Experience after the evaluation of 700 potential donors for living donor liver transplantation in a single center. Liver Transpl 10:91087–96
    [Google Scholar]
  38. 38.  Marcos A, Fisher RA, Ham JM et al. 2000. Selection and outcome of living donors for adult to adult right lobe transplantation. Transplantation 69:112410–15
    [Google Scholar]
  39. 39.  Goldaracena N, Sapisochin G, Spetzler V et al. 2016. Live donor liver transplantation with older (≥50 years) versus younger (<50 years) donors: Does age matter?. Ann. Surg. 263:5979–85
    [Google Scholar]
  40. 40.  Shah SA, Cattral MS, McGilvray ID et al. 2007. Selective use of older adults in right lobe living donor liver transplantation. Am. J. Transpl. 7:1142–50
    [Google Scholar]
  41. 41.  Han JH, You YK, Na GH et al. 2014. Outcomes of living donor liver transplantation using elderly donors. Ann. Surg. Treat. Res. 86:4184–91
    [Google Scholar]
  42. 42.  Dayangac M, Taner CB, Yaprak O et al. 2011. Utilization of elderly donors in living donor liver transplantation: When more is less?. Liver Transpl 17:5548–55
    [Google Scholar]
  43. 43.  Trotter JF, Wisniewski KA, Terrault NA et al. 2007. Outcomes of donor evaluation in adult-to-adult living donor liver transplantation. Hepatology 46:51476–84
    [Google Scholar]
  44. 44.  Knaak M, Goldaracena N, Doyle A et al. 2017. Donor BMI >30 is not a contraindication for live liver donation. Am. J. Transpl. 17:3754–60
    [Google Scholar]
  45. 45.  Ito T, Kiuchi T, Egawa H et al. 2003. Surgery-related morbidity in living donors of right-lobe liver graft: lessons from the first 200 cases. Transplantation 76:1158–63
    [Google Scholar]
  46. 46.  Iida T, Ogura Y, Oike F et al. 2010. Surgery-related morbidity in living donors for liver transplantation. Transplantation 89:101276–82
    [Google Scholar]
  47. 47.  Moss J, Lapointe-Rudow D, Renz JF et al. 2005. Select utilization of obese donors in living donor liver transplantation: implications for the donor pool. Am. J. Transpl. 5:122974–81
    [Google Scholar]
  48. 48.  Soejima Y, Shimada M, Sugimachi K et al. 2003. Use of steatotic graft in living-donor liver transplantation. Transplantation 76:2344–48
    [Google Scholar]
  49. 49.  Uemoto S, Sugiyama K, Marusawa H et al. 1998. Transmission of hepatitis B virus from hepatitis B core antibody-positive donors in living related liver transplants. Transplantation 65:4494–99
    [Google Scholar]
  50. 50.  Pomfret EA, Pomposelli JJ, Gordon FD et al. 2003. Liver regeneration and surgical outcome in donors of right-lobe liver grafts. Transplantation 76:15–10
    [Google Scholar]
  51. 51.  Gruttadauria S, Parikh V, Pagano D et al. 2012. Early regeneration of the remnant liver volume after right hepatectomy for living donation: a multiple regression analysis. Liver Transpl 18:8907–13
    [Google Scholar]
  52. 52.  Kim SJ, Na GH, Choi HJ et al. 2013. Effect of donor right hepatectomy on splenic volume and platelet count for living donor liver transplantation. J. Gastrointest. Surg. 17:91576–83
    [Google Scholar]
  53. 53.  Everson GT, Hoefs JC, Niemann CU et al. 2013. Functional elements associated with hepatic regeneration in living donors after right hepatic lobectomy. Liver Transpl 19:3292–304
    [Google Scholar]
  54. 54.  Emond JC, Fisher RA, Everson G et al. 2015. Changes in liver and spleen volumes after living liver donation: a report from the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL). Liver Transpl 21:2151–61
    [Google Scholar]
  55. 55.  Beavers KL, Sandler RS, Shrestha R 2002. Donor morbidity associated with right lobectomy for living donor liver transplantation to adult recipients: a systematic review. Liver Transpl 8:2110–17
    [Google Scholar]
  56. 56.  Ghobrial RM, Freise CE, Trotter JF et al. 2008. Donor morbidity after living donation for liver transplantation. Gastroenterology 135:2468–76
    [Google Scholar]
  57. 57.  Abecassis MM, Fisher RA, Olthoff KM et al. 2012. Complications of living donor hepatic lobectomy—a comprehensive report. Am. J. Transpl. 12:51208–17
    [Google Scholar]
  58. 58.  Cheah YL, Simpson MA, Pomposelli JJ et al. 2013. Incidence of death and potentially life-threatening near-miss events in living donor hepatic lobectomy: a world-wide survey. Liver Transpl 19:5499–506
    [Google Scholar]
  59. 59.  Adcock L, Macleod C, Dubay D et al. 2010. Adult living liver donors have excellent long-term medical outcomes: the University of Toronto liver transplant experience. Am. J. Transpl. 10:2364–71
    [Google Scholar]
  60. 60.  Marsh JW, Gray E, Ness R et al. 2009. Complications of right lobe living donor liver transplantation. J. Hepatol. 51:4715–24
    [Google Scholar]
  61. 61.  Verbesey JE, Simpson MA, Pomposelli JJ et al. 2005. Living donor adult liver transplantation: a longitudinal study of the donor's quality of life. Am. J. Transpl. 5:112770–77
    [Google Scholar]
  62. 62.  Trotter JF, Hill-Callahan MM, Gillespie BW et al. 2007. Severe psychiatric problems in right hepatic lobe donors for living donor liver transplantation. Transplantation 83:111506–8
    [Google Scholar]
  63. 63.  Brown RS, Smith AR, Dew MA et al. 2014. Predictors of donor follow-up after living donor liver transplantation. Liver Transpl 20:8967–76
    [Google Scholar]
  64. 64.  DuBay DA, Holtzman S, Adcock L et al. 2009. Adult right-lobe living liver donors: quality of life, attitudes and predictors of donor outcomes. Am. J. Transpl. 9:51169–78
    [Google Scholar]
  65. 65.  Parikh ND, Ladner D, Abecassis M et al. 2010. Quality of life for donors after living donor liver transplantation: a review of the literature. Liver Transpl 16:121352–58
    [Google Scholar]
  66. 66.  Feltrin A, Pegoraro R, Rago C et al. 2008. Experience of donation and quality of life in living kidney and liver donors. Transpl. Int. 21:5466–72
    [Google Scholar]
  67. 67.  Dew MA, DiMartini AF, Ladner DP et al. 2016. Psychosocial outcomes 3 to 10 years after donation in the Adult to Adult Living Donor Liver Transplantation Cohort Study. Transplantation 100:61257–69
    [Google Scholar]
  68. 68.  Butt Z, Dew MA, Liu Q et al. 2017. Psychological outcomes of living liver donors from a multicenter prospective study: results from the Adult-to-Adult Living Donor Liver Transplantation Cohort Study2 (A2ALL-2). Am. J. Transpl. 17:51267–77
    [Google Scholar]
  69. 69.  DiMartini A, Dew MA, Liu Q et al. 2017. Social and financial outcomes of living liver donation: a prospective investigation within the Adult-to-Adult Living Donor Liver Transplantation Cohort Study 2 (A2ALL-2). Am. J. Transpl. 17:41081–96
    [Google Scholar]
  70. 70.  Mange KC, Joffe MM, Feldman HI 2001. Effect of the use or nonuse of long-term dialysis on the subsequent survival of renal transplants from living donors. N. Engl. J. Med. 344:10726–31
    [Google Scholar]
  71. 71.  Mange KC, Weir MR 2003. Preemptive renal transplantation: Why not?. Am. J. Transpl. 3:111336–40
    [Google Scholar]
  72. 72.  Berg CL, Merion RM, Shearon TH et al. 2011. Liver transplant recipient survival benefit with living donation in the model for endstage liver disease allocation era. Hepatology 54:41313–21
    [Google Scholar]
  73. 73.  Merion RM, Schaubel DE, Dykstra DM et al. 2005. The survival benefit of liver transplantation. Am. J. Transpl. 5:2307–13
    [Google Scholar]
  74. 74.  Heuman DM, Abou-Assi SG, Habib A et al. 2004. Persistent ascites and low serum sodium identify patients with cirrhosis and low MELD scores who are at high risk for early death. Hepatology 40:4802–10
    [Google Scholar]
  75. 75.  Patidar KR, Thacker LR, Wade JB et al. 2014. Covert hepatic encephalopathy is independently associated with poor survival and increased risk of hospitalization. Am. J. Gastroenterol. 109:111757–63
    [Google Scholar]
  76. 76.  Somsouk M, Kornfield R, Vittinghoff E et al. 2011. Moderate ascites identifies patients with low model for end-stage liver disease scores awaiting liver transplantation who have a high mortality risk. Liver Transpl 17:2129–36
    [Google Scholar]
  77. 77.  Wedd J, Bambha KM, Stotts M et al. 2014. Stage of cirrhosis predicts the risk of liver-related death in patients with low model for end-stage liver disease scores and cirrhosis awaiting liver transplantation. Liver Transpl 20:101193–201
    [Google Scholar]
  78. 78.  Liang W, Wu L, Ling X et al. 2012. Living donor liver transplantation versus deceased donor liver transplantation for hepatocellular carcinoma: a meta-analysis. Liver Transpl 18:101226–36
    [Google Scholar]
  79. 79.  Trotter JF 2000. Selection of donors and recipients for living donor liver transplantation. Liver Transpl 6:6 Suppl. 2S52–58
    [Google Scholar]
  80. 80.  DuBay D, Sandroussi C, Sandhu L et al. 2011. Liver transplantation for advanced hepatocellular carcinoma using poor tumor differentiation on biopsy as an exclusion criterion. Ann. Surg. 253:1166–72
    [Google Scholar]
  81. 81.  Lee JH, Cho Y, Kim HY et al. 2016. Serum tumor markers provide refined prognostication in selecting liver transplantation candidate for hepatocellular carcinoma patients beyond the Milan criteria. Ann. Surg. 263:5842–50
    [Google Scholar]
  82. 82.  Llovet JM, Pavel M, Rimola J et al. 2018. Pilot study of living donor liver transplantation for patients with hepatocellular carcinoma exceeding Milan criteria (Barcelona Clinic Liver Cancer extended criteria). Liver Transpl 24:3369–79
    [Google Scholar]
  83. 83.  Clavien PA, Lesurtel M, Bossuyt PM et al. 2012. Recommendations for liver transplantation for hepatocellular carcinoma: an international consensus conference report. Lancet Oncol 13:1e11–22
    [Google Scholar]
  84. 84.  Niranjan-Azadi AM, Kabacam G, Durand CM et al. 2017. Single-center experience in pre-transplant hepatitis C virus (HCV) treatment among living donor liver transplant candidates: bridging the direct-acting antivirals (DAA). Ann. Transpl. 22:570–74
    [Google Scholar]
  85. 85.  Kim WR, Lake JR, Smith JM et al. 2018. OPTN/SRTR 2016 annual data report: liver. Am. J. Transpl. 18:Suppl. 1172–53
    [Google Scholar]
  86. 86.  Yeh H, Smoot E, Schoenfeld DA et al. 2011. Geographic inequity in access to livers for transplantation. Transplantation 91:4479–86
    [Google Scholar]
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