Skip to main content

Advertisement

SpringerLink
Log in

Living-donor liver transplantation: an overview

  • Published:
Journal of Hepato-Biliary-Pancreatic Surgery

Abstract

It has been 16 years since the first successful living-donor liver transplant was performed from a parent to a child. The overall recipient and graft survival, together with a low morbidity and mortality in donors, have resulted in the widespread acceptance of the procedure by both the transplant community and the public at large. Adult-to-adult living-donor liver transplantation has been evolving over the past decade. Despite living-donor transplant patients being better-risk candidates than those who receive a graft from a deceased donor, and well-established and experienced units achieving satisfactory results, overall recipient and graft survival recorder by registries can only be described as suboptimal. This, combined with the high morbidity and not-insignificant mortality amongst donors makes expansion of adult-to-adult liver transplantation hard to justify on a risk-benefit analysis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. R Strong S Lynch T Ong H Matsunami Y Koido G Balderson (1990) ArticleTitleSuccessful liver transplantation from a living donor to her son N Engl J Med 322 1505–7 Occurrence Handle2336076 Occurrence Handle1:STN:280:DyaK3c3ksFSnsA%3D%3D Occurrence Handle10.1056/NEJM199005243222106

    Article  PubMed  CAS  Google Scholar 

  2. R Strong T Ong P Pillay D Wall G Balderson S Lynch (1988) ArticleTitleA new method of segmental orthotopic liver transplantation in children Surgery 104 104–8 Occurrence Handle3291166 Occurrence Handle1:STN:280:DyaL1c3msVOiug%3D%3D

    PubMed  CAS  Google Scholar 

  3. N Nagasue H Kohno S Matsuo A Yamanoi M Uchida Y Takemoto et al. (1992) ArticleTitleSegmental (partial) liver transplantation from a living donor Transpl Proc 24 1958–9 Occurrence Handle1:STN:280:DyaK3s%2Fjt1CjtQ%3D%3D

    CAS  Google Scholar 

  4. C Broelsch J Emond P Whitington Thistlethwaite A Baker J Lichtor (1990) ArticleTitleApplication of reduced-size liver transplants as split grafts, auxiliary orthotopic grafts and living related segmental transplants Ann Surg 212 368–75 Occurrence Handle2396888 Occurrence Handle1:STN:280:DyaK3cznt1Omsg%3D%3D

    PubMed  CAS  Google Scholar 

  5. Y Hashikura M Makuuchi S Kawasaki H Matsunami T Ikegami Y Nakazawa et al. (1994) ArticleTitleSuccessful living related partial liver transplantation to an adult patient Lancet 343 1233–4 Occurrence Handle7909905 Occurrence Handle1:STN:280:DyaK2c3jtFyquw%3D%3D Occurrence Handle10.1016/S0140-6736(94)92450-3

    Article  PubMed  CAS  Google Scholar 

  6. J Emond J Renz L Ferrell P Rosenthal R Lim J Roberts et al. (1996) ArticleTitleFunctional analysis of grafts from living donors: implications for the treatment of older recipients Ann Surg 224 544–54 Occurrence Handle8857858 Occurrence Handle1:STN:280:DyaK2s%2FhtVyhtw%3D%3D Occurrence Handle10.1097/00000658-199610000-00012

    Article  PubMed  CAS  Google Scholar 

  7. S Miyagawa Y Hashikura S Miwa T Ikegami K Urata M Terada et al. (1998) ArticleTitleConcomitant caudate lobe resection as an option for donor hepatectomy in adult living related liver transplantation Transplantation 66 661–3 Occurrence Handle9753351 Occurrence Handle1:STN:280:DyaK1cvisVaksQ%3D%3D Occurrence Handle10.1097/00007890-199809150-00021

    Article  PubMed  CAS  Google Scholar 

  8. Y Yamaoka M Washida K Honda K Tanaka K Mori Y Shimahara et al. (1994) ArticleTitleLiver transplantation using a right lobe graft from a living related donor Transplantation 57 1127–30 Occurrence Handle8165712 Occurrence Handle1:STN:280:DyaK2c3hvV2rsA%3D%3D

    PubMed  CAS  Google Scholar 

  9. CM Lo ST Fan CL Liu WL Wei RJ Lo CL Lai et al. (1997) ArticleTitleAdult to adult living donor liver transplantation using extended right lobe grafts Ann Surg 226 261–9 Occurrence Handle9339932 Occurrence Handle1:STN:280:DyaK2svnvFymsw%3D%3D Occurrence Handle10.1097/00000658-199709000-00005

    Article  PubMed  CAS  Google Scholar 

  10. B Gridelli M Spada W Petz A Bertani A Luciassetti M Colledan et al. (2003) ArticleTitleSplit-liver transplantation eliminates the need for living donor liver transplantation in children with end-stage cholestatic liver disease Transplantation 75 1197–203 Occurrence Handle12717203 Occurrence Handle10.1097/01.TP.0000061940.96949.A1

    Article  PubMed  Google Scholar 

  11. K Mori I Nagata S Yamagata H Sasaki F Nishizawa Y Takada et al. (1992) ArticleTitleThe introduction of microvascular surgery to hepatic artery reconstruction in living donor liver transplantation — its advantages compared with conventional procedures Transplantation 54 263–8 Occurrence Handle1496539 Occurrence Handle1:STN:280:DyaK38zlvVGjsg%3D%3D

    PubMed  CAS  Google Scholar 

  12. Y Hashikura S Kawasaki N Okumura S Ishikawa H Matsumami T Ikegami et al. (1995) ArticleTitlePrevention of hepatic artery thrombosis in pediatric liver transplantation Transplantation 60 1109–12 Occurrence Handle7482717 Occurrence Handle1:STN:280:DyaK28%2FotlymtQ%3D%3D

    PubMed  CAS  Google Scholar 

  13. D Cronin E Alonso J Piper K Newell D Bruce E Woodle et al. (1997) ArticleTitleBiliary complications in living related donor liver transplantation Transpl Proc 29 419–20 Occurrence Handle10.1016/S0041-1345(96)00160-1

    Article  Google Scholar 

  14. H Egawa S Uemoto Y Inomata A Shapiro K Asonuma T Kiuchi et al. (1998) ArticleTitleBiliary complications in pediatric living related liver transplantation Surgery 124 901–10 Occurrence Handle9823405 Occurrence Handle1:STN:280:DyaK1M%2FktVOguw%3D%3D

    PubMed  CAS  Google Scholar 

  15. JB Otte (2004) ArticleTitlePaediatric liver transplantation — a review based on 20 years of personal experience Transpl Int 17 562–73 Occurrence Handle15592713

    PubMed  Google Scholar 

  16. H Yersig J Renz D Farmer G Hisatake S Mc Diamond R Busuttil (2003) ArticleTitleOne hundred in situ split-liver transplantations: a single center experience Ann Surg 238 496–505

    Google Scholar 

  17. K Tanaka (2003) ArticleTitleProgress and future in living donor liver transplantation Keio J Med 52 73–9 Occurrence Handle12862357

    PubMed  Google Scholar 

  18. S Kawasaki M Makuuchi H Matsunami Y Hashikura T Ikegami Y Nakagawa et al. (1998) ArticleTitleLiving related liver transplantation in adults Ann Surg 227 269–74 Occurrence Handle9488526 Occurrence Handle1:STN:280:DyaK1c7kslymsg%3D%3D Occurrence Handle10.1097/00000658-199802000-00017

    Article  PubMed  CAS  Google Scholar 

  19. Y Sugawara M Makuuchi (2004) ArticleTitleAdvances in adult living donor liver transplantation; a review based on reports from the Tenth Anniversary of Adult-to-Adult Living Donor Liver Transplantation meeting in Tokyo Liver Transpl 10 715–20 Occurrence Handle15162463 Occurrence Handle10.1002/lt.20179

    Article  PubMed  Google Scholar 

  20. Y Soejima M Shimada T Suehiro S Hiroshige M Ninomiya S Shiotani et al. (2003) ArticleTitleOutcome analysis in adult-to-adult living donor liver transplantation using the left lobe Liver Transpl 9 581–6 Occurrence Handle12783399 Occurrence Handle10.1053/jlts.2003.50114

    Article  PubMed  Google Scholar 

  21. S Hwang SG Lee TY Ha CS Ahn KM Park KH Kim et al. (2004) ArticleTitleSimplified standardized technique for living donor liver transplantation using left liver graft plus caudate lobe Liver Transpl 10 1398–405 Occurrence Handle15497157 Occurrence Handle10.1002/lt.20241

    Article  PubMed  Google Scholar 

  22. Y Sugawara M Makuuchi J Kaneko Kokudo (2003) ArticleTitleMELD score for selection of patients to receive a left liver graft Transplantation 75 573–4 Occurrence Handle12605135 Occurrence Handle10.1097/01.TP.0000045710.78341.9B

    Article  PubMed  Google Scholar 

  23. SG Lee KM Park S Hwang YJ Lee DN Choi KH Kim et al. (2001) ArticleTitleCongestion of right liver graft in living donor transplantation Transplantation 71 812–4 Occurrence Handle11330547 Occurrence Handle1:STN:280:DC%2BD3MzntVCqtA%3D%3D Occurrence Handle10.1097/00007890-200103270-00021

    Article  PubMed  CAS  Google Scholar 

  24. Y Sugawara M Makuuchi (2004) ArticleTitleAdvances in adult living donor liver transplantation: a review based on reports from the 10th anniversary of the adult-to-adult living donor liver transplantation meeting in Tokyo Liver Transpl 10 715–20 Occurrence Handle15162463 Occurrence Handle10.1002/lt.20179

    Article  PubMed  Google Scholar 

  25. K Sano M Makuuchi K Miki A Maema Y Sugawara H Imamura et al. (2002) ArticleTitleEvaluation of hepatic venous congestion: proposed indication criteria for hepatic vein reconstruction Ann Surg 236 241–7 Occurrence Handle12170030 Occurrence Handle10.1097/00000658-200208000-00013

    Article  PubMed  Google Scholar 

  26. R Ghobrial R Busuttil (2003) ArticleTitleFuture of adult living donor liver transplantation Liver Transpl 9 IssueIDSuppl 2 S73–9 Occurrence Handle14528434 Occurrence Handle10.1053/jlts.2003.50230

    Article  PubMed  Google Scholar 

  27. R Adam P McMaster J O'Grady D Castaing J Klempnauer N Jamieson et al. (2003) ArticleTitleEvolution of liver transplantation in Europe: report of the European Liver Transplant Registry Liver Transpl 9 1231–43 Occurrence Handle14625822 Occurrence Handle10.1016/j.lts.2003.09.018

    Article  PubMed  Google Scholar 

  28. P Thuluvath H Yoo (2004) ArticleTitleGraft and patient survival after adult live donor liver transplantation compared to a matched cohort who received a deceased donor transplantation Liver Transpl 10 1263–8 Occurrence Handle15376301 Occurrence Handle10.1002/lt.20254

    Article  PubMed  Google Scholar 

  29. A Humar (2003) ArticleTitleDonor and recipient outcomes after adult living donor liver transplantation Liver Transpl 9 IssueIDSuppl 2 S42–4 Occurrence Handle14528427 Occurrence Handle10.1053/jlts.2003.50219

    Article  PubMed  Google Scholar 

  30. R Freeman (2003) ArticleTitleThe impact of the Model for End-stage Liver Disease on recipient selection for adult living liver donation Liver Transpl 9 IssueIDSuppl 2 S54–9 Occurrence Handle14528430 Occurrence Handle10.1053/jlts.2003.50223

    Article  PubMed  Google Scholar 

  31. A Marcos J Ham R Fisher A Olzinski M Posner (2000) ArticleTitleSingle center analysis of the first 40 adult-to-adult living donor liver transplants using the right lobe Liver Transpl 6 296–301 Occurrence Handle10827229 Occurrence Handle1:STN:280:DC%2BD3c3oslyqsg%3D%3D Occurrence Handle10.1053/lv.2000.6354

    Article  PubMed  CAS  Google Scholar 

  32. SG Lee KM Park S Hwang YJ Lee KH Kim CS Ahn et al. (2002) ArticleTitleAdult-to-adult living donor liver transplantation at the Asan Medical Center Korea Asian J Surg 25 277–84 Occurrence Handle12470999 Occurrence Handle1:STN:280:DC%2BD38jgvVKmug%3D%3D Occurrence Handle10.1016/S1015-9584(09)60192-5

    Article  PubMed  CAS  Google Scholar 

  33. T Bak M Wachs J Trotter G Everson T Trovillot M Kugelmas et al. (2001) ArticleTitleAdult-to-adult living donor liver transplantation using right lobe grafts: results and lessons learned from a single center experience Liver Transpl 7 680–6 Occurrence Handle11510011 Occurrence Handle1:STN:280:DC%2BD3MvmsVOlug%3D%3D Occurrence Handle10.1053/jlts.2001.26509

    Article  PubMed  CAS  Google Scholar 

  34. H Grewal J Thistlethwaite G Loss J Fisher D Cronin C Siegel et al. (1998) ArticleTitleComplications in 100 living liver donors Ann Surg 228 214–9 Occurrence Handle9712567 Occurrence Handle1:STN:280:DyaK1czns1CisA%3D%3D Occurrence Handle10.1097/00000658-199808000-00011

    Article  PubMed  CAS  Google Scholar 

  35. S Fujita ID Kim K Uryuhara K Asonuma H Egawa T Kiuchi et al. (2000) ArticleTitleHepatic grafts from live donors: donor morbidity for 470 cases of live donation Transpl Int 13 333–9 Occurrence Handle11052268 Occurrence Handle1:STN:280:DC%2BD3crgtlOiug%3D%3D Occurrence Handle10.1007/s001470050710

    Article  PubMed  CAS  Google Scholar 

  36. J Renz J Roberts (2000) ArticleTitleLong-term complications of living donor liver transplantation Liver Transpl 6 IssueIDSuppl 2 S73–6 Occurrence Handle11084090 Occurrence Handle1:STN:280:DC%2BD3M%2FmtlGjsg%3D%3D Occurrence Handle10.1053/jlts.2000.18686

    Article  PubMed  CAS  Google Scholar 

  37. K Umeshita K Fujiwara K Kiyosawa M Makuuchi S Satomi K Sugimachi et al. (2003) ArticleTitleOperative morbidity of living liver donors in Japan Lancet 362 687–90 Occurrence Handle12957090 Occurrence Handle10.1016/S0140-6736(03)14230-4

    Article  PubMed  Google Scholar 

  38. Lo CM (2003) ArticleTitleComplications and long-term outcome of living liver donors: a survey of 1508 cases in five Asian centers Transplantation 75 IssueIDSuppl S12–5

    Google Scholar 

  39. P Salvalaggio T Baker A Koffron (2004) ArticleTitleComparative analysis of live liver donation risk using a comprehensive grading system of severity Transplantation 77 1765–7 Occurrence Handle15201680 Occurrence Handle10.1097/01.TP.0000129406.35825.6D

    Article  PubMed  Google Scholar 

  40. E Pomfret (2003) ArticleTitleEarly and late complications in the right lobe adult living donor Liver Transpl 9 IssueIDSuppl 2 S45–9 Occurrence Handle14528428 Occurrence Handle10.1053/jlts.2003.50231

    Article  PubMed  Google Scholar 

  41. M Shiffman R Brown K Olthoff G Everson C Miller M Siegler et al. (2002) ArticleTitleLiving donor liver transplantation. Summary of a conference at the National Institutes of Health Liver Transpl 8 174–88 Occurrence Handle11862598 Occurrence Handle10.1053/jlts.2002.30981

    Article  PubMed  Google Scholar 

  42. R Strong (1999) ArticleTitleWhither living donor liver transplantation (editorial) Liver Transpl Surg 5 536–8 Occurrence Handle10545545 Occurrence Handle1:STN:280:DC%2BD3c%2FhsFejuw%3D%3D Occurrence Handle10.1002/lt.500050613

    Article  PubMed  CAS  Google Scholar 

  43. P Hayashi J Trotter (2002) ArticleTitleReview article: adult-to-adult right hepatic lobe living donor liver transplantation Aliment Pharmacol Ther 16 1833–41 Occurrence Handle12390092 Occurrence Handle1:STN:280:DC%2BD38njt1Snuw%3D%3D Occurrence Handle10.1046/j.1365-2036.2002.01361.x

    Article  PubMed  CAS  Google Scholar 

  44. A Pascher I Sauer M Walter E Lopez-Haeninnen T Theruvath A Spinelli et al. (2002) ArticleTitleDonor evaluation, donor risks, donor outcome and donor quality of life in adult-to-adult living donor liver transplantation Liver Transpl 8 829–37 Occurrence Handle12200786 Occurrence Handle10.1053/jlts.2002.34896

    Article  PubMed  Google Scholar 

  45. R Brown M Russo M Lai M Shiffman M Richardson J Everhart et al. (2003) ArticleTitleA survey of liver transplantation from living adult donors in the United States N Engl J Med 348 818–25 Occurrence Handle12606737 Occurrence Handle10.1056/NEJMsa021345

    Article  PubMed  Google Scholar 

  46. RG Simmons S Klein RL Simmons (1997) Living related donors; costs and gains RG Simmons S Klein RL Simmons (Eds) Gift of life: the social and psychological impact of organ transplantation Wiley and Sons New York, NY 153–97

    Google Scholar 

  47. M Potts (2002) ArticleTitleCorrespondence J N Engl Med 347 616

    Google Scholar 

  48. P Singer M Siegler P Whitington J Lantos J Emond J Thistlethwaite et al. (1989) ArticleTitleEthics of liver transplantation with living donors N Engl J Med 321 620–2 Occurrence Handle2668769 Occurrence Handle1:STN:280:DyaL1MzksVWqsw%3D%3D Occurrence Handle10.1056/NEJM198908313210919

    Article  PubMed  CAS  Google Scholar 

  49. R Shapiro M Adams (2000) ArticleTitleEthical issues surrounding adult-to-adult living donor liver transplantation Liver Transpl 6 IssueIDSuppl 2 S77–80 Occurrence Handle11084091 Occurrence Handle1:STN:280:DC%2BD3M%2FmtlGjsw%3D%3D Occurrence Handle10.1053/jlts.2000.19014

    Article  PubMed  CAS  Google Scholar 

  50. A Spital M Spital (1990) ArticleTitleThe ethics of liver transplantation from a living donor N Engl J Med 322 549–50 Occurrence Handle2300125 Occurrence Handle1:STN:280:DyaK3c7js1OksA%3D%3D Occurrence Handle10.1056/NEJM199002223220811

    Article  PubMed  CAS  Google Scholar 

  51. FD Moore (1998) ArticleTitleThree ethical revolutions: ancient assumptions remodeled under pressure of transplantation Transplant Proc 20 IssueIDSuppl 1 1061–7

    Google Scholar 

  52. OS Surman (2002) ArticleTitleThe ethics of partial liver donation N Engl J Med 346 1038 Occurrence Handle11932469 Occurrence Handle10.1056/NEJM200204043461402

    Article  PubMed  Google Scholar 

  53. L Fukunishi Y Sugawara T Takayama M Makuuchi H Kawarasaki OS Surman (2001) ArticleTitlePsychiatric disorders before and after living-related transplantation Psychosomatics 42 337–43 Occurrence Handle11496023 Occurrence Handle1:STN:280:DC%2BD3MvkvFegsw%3D%3D Occurrence Handle10.1176/appi.psy.42.4.337

    Article  PubMed  CAS  Google Scholar 

  54. M Malago G Testa A Marcos S Fung M Siegler M Cronin et al. (2001) ArticleTitleEthical considerations and rationale of adult-to-adult living donor liver transplantation Liver Transpl 7 921–7 Occurrence Handle11679994 Occurrence Handle1:STN:280:DC%2BD3MrntVGgsA%3D%3D Occurrence Handle10.1053/jlts.2001.28301

    Article  PubMed  CAS  Google Scholar 

  55. K Tanaka Y Ogura T Kiuchi Y Inomata S Uemoto H Furukawa (2004) ArticleTitleLiving donor liver transplantation: Eastern experiences HPB 6 88–94 Occurrence Handle1:STN:280:DC%2BD1c7ntlyntg%3D%3D Occurrence Handle18333056

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Queensland, Princess Alexandra Hospital, Ipswich Road, Brisbane, 4102, Australia

    Russell W. Strong

Authors
  1. Russell W. Strong
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Strong, R. Living-donor liver transplantation: an overview. J Hepatobiliary Pancreat Surg 13, 370–377 (2006). https://doi.org/10.1007/s00534-005-1076-y

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00534-005-1076-y

Key words

Search

Navigation