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Living donor liver transplantation

Goldaracena, Nicolasa; Barbas, Andrew S.b

Current Opinion in Organ Transplantation: April 2019 - Volume 24 - Issue 2 - p 131–137
doi: 10.1097/MOT.0000000000000610
LIVER TRANSPLANTATION: Edited by Sophoclis P. Alexopoulos

Purpose of review As experience grows, living donor liver transplantation (LDLT) has become an effective treatment option to overcome the deceased donor organ shortage.

Recent findings Donor safety is the highest priority in LDLT. Strict donor selection according to structured protocols and center experience are the main factors that determine donor safety. However, with increased experience, many centers have explored increasing organ availability within living donation by means of ABO incompatible LDLT, dual graft LDLT, and anonymous living donation. Also, this growing experience in LDLT has allowed the transplant community to cautiously explore the role of liver transplantation for hepatocellular carcinoma outside of Milan criteria and patients with unresectable colorectal liver metastases.

Summary LDLT has become established as a viable strategy to ameliorate the organ shortage experienced by centers around the world. Improved understanding of this technique has allowed the improved utilization of live donor graft resources, without compromising donor safety. Moreover, LDLT may offer some advantages over deceased donor liver transplantation and a unique opportunity to assess the broader applicability of liver transplantation.

aDivision of Transplant Surgery, Department of Surgery, University of Virginia, Charlottesville, Virginia

bDivision of Abdominal Transplant Surgery, Department of Surgery, Duke University, Durham, North Carolina, USA

Correspondence to Nicolas Goldaracena, MD, Division of Transplant Surgery, Department of Surgery, University of Virginia, Charlottesville, VA 22908, USA. E-mail:

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