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Review
. 2016 Apr;5(2):133-40.
doi: 10.3978/j.issn.2304-3881.2015.06.01.

Living donor liver transplantation in the USA

Peter T W Kim  1 , Giuliano Testa  1
Affiliations
Review

Living donor liver transplantation in the USA

Peter T W Kim et al. Hepatobiliary Surg Nutr. 2016 Apr.

Abstract

Living donor liver transplant (LDLT) accounts for a small volume of the transplants in the USA. Due to the current liver allocation system based on the model for end-stage liver disease (MELD), LDLT has a unique role in providing life-saving transplantation for patients with low MELD scores and significant complications from portal hypertension, as well as select patients with hepatocellular carcinoma (HCC). Donor safety is paramount and has been a topic of much discussion in the transplant community as well as the general media. The donor risk appears to be low overall, with a favorable long-term quality of life. The latest trend has been a gradual shift from right-lobe grafts to left-lobe grafts to reduce donor risk, provided that the left lobe can provide adequate liver volume for the recipient.

Keywords: Donor risk; left-lobe graft; liver transplantation; living donor; mortality.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Trends in the numbers of new patients on the liver transplant wait list, deceased donor liver transplants, and living donor liver transplants in the USA from 1997 to 2013.
Figure 2
Figure 2
Geographic map showing the 11 regions of the United Network of Organ Sharing (UNOS) in the USA.
Figure 3
Figure 3
The number of deceased donor liver transplants (DDLTs) and living donor liver transplants (LDLTs) performed in 2013 by United Network of Organ Sharing (UNOS) region, based on data from UNOS.
Figure 4
Figure 4
The probability of death for patients on the liver transplant waiting list, patients who undergo living donor liver transplant (LDLT) at centers with minimal experience, patients who undergo deceased donor liver transplant (DDLT), and patients who undergo LDLT at experienced centers. The data indicate that from years 1 to 4, more patients who undergo LDLT at experienced centers are alive compared with all other categories. Reprinted with permission from Berg et al., 2007 (20).
See this image and copyright information in PMC

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