LIVER TRANSPLANTATION: Edited by Srinath ChinnakotlaCurrent status of adult liver transplantation: utilization of living donor versus deceased donor graftTran, Lillian; Humar, AbhinavAuthor Information Thomas E. Starzl Transplantation Institute, Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA Correspondence to Abhinav Humar, MD Chief, Division of Abdominal Transplantation Surgery Clinical Director, Thomas E. Starzl Transplantation Institute 3459 Fifth Avenue, N723 Pittsburgh, Pennsylvania 15213, USA. Tel: +412 692 4553; e-mail: [email protected] Current Opinion in Organ Transplantation: April 2021 - Volume 26 - Issue 2 - p 133-138 doi: 10.1097/MOT.0000000000000849 Buy Metrics Abstract Purpose of review This article will summarize prior and recent studies comparing outcomes between living donor and deceased donor liver transplantation (LT) in adults and provide a rationale and framework for expanding living donor liver transplantation (LDLT) in Western countries to address the growing critical organ shortage. Recent findings There is a growing body of evidence demonstrating superior survival outcomes in LDLT in addition to a multitude of other advantages including shorter cold ischemia times, opportunity for pretransplant medical optimization, and expansion of transplant eligibility. Additionally, these outcomes continue to improve with center volume and experience. Summary LDLT in adults emerged in response to an effective donor organ shortage created by the critical discrepancy between donor graft supply and demand. Overcoming this organ shortage and an increasing waitlist mortality requires a liver transplant framework that fully integrates LDLT into liver disease management although continuing to fully maximize deceased donor graft utilization at experience, capable centers. Optimizing both living and deceased donor graft utilization will drastically increase patients’ access to LT. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.