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Progression of living liver donation worldwide

Nydam, Trevor L.a; Reddy, Mettu Srinivasb; Pomfret, Elizabeth A.a; Rela, Mohamedb

Current Opinion in Organ Transplantation: April 2018 - Volume 23 - Issue 2 - p 162–168
doi: 10.1097/MOT.0000000000000516
LIVER TRANSPLANTATION: Edited by R. Mark Ghobrial

Purpose of review Living donor liver transplantation (LDLT) has developed into a well tolerated and viable option when deceased donor transplantation is not available. Transplant and advanced hepatobiliary surgeons from around the world have performed living donor hepatectomies consistently for decades with acceptable donor outcomes. However, optimizing the preoperative workup, donor selection, operative technique, and perioperative care will improve these outcomes. This manuscript reviews recent worldwide literature for the living liver donor.

Recent findings Overall, younger living donors produce better recipient outcomes but with careful selection donor over 55 years old may be used safely. Magnetic resonance is becoming the imaging of choice for living donor preoperative planning and its ability to predict steatosis may make predonation liver biopsy unnecessary. Programs with experience in LDLT and laparoscopic liver resection are making significant progress toward consistent use of the laparoscopic approach to living donor hepatectomy. Biliary, pulmonary, and infectious complications are the predictable complications with more serious complications and donor death being very rare. In a majority of cases, the donor's health-related quality of life and psychological well being are preserved.

Summary These recent findings will allow us to better care for the living liver donor and enable LDLT continued progress.

aUniversity of Colorado School of Medicine, Aurora, Colorado, USA

bInstitute of Liver Disease and Transplantation, Global Hospital and Health City, Chennai, Tamil Nadu, India

Correspondence to Trevor L. Nydam, MD, Division of Transplant Surgery, Anschutz Medical Campus, University of Colorado, C-318, 1635 Aurora Court, Aurora, CO 80045-2541, USA. E-mail:

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