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. 2023 Jul;37(7):e14953.
doi: 10.1111/ctr.14953. Epub 2023 Mar 20.

Living donor liver transplantation: A multi-disciplinary collaboration towards growth, consensus, and a change in culture

AnnMarie Liapakis  1 , Michelle T Jesse  2 , Anjana Pillai  3 , Therese Bittermann  4 , Mary Amanda Dew  5 , Sukru Emre  6 , Heather Hunt  7 , Vineeta Kumar  8 , Jayme Locke  8 , Saeed Mohammad  9 , Kim Olthoff  10 , Elizabeth C Verna  11 , Krista L Lentine  12 ; LDLT Consensus Conference Working Group
Affiliations

Living donor liver transplantation: A multi-disciplinary collaboration towards growth, consensus, and a change in culture

AnnMarie Liapakis et al. Clin Transplant. 2023 Jul.

Abstract

Introduction: Living donor liver transplantation (LDLT) reduces liver transplant waitlist mortality and provides excellent long-term outcomes for persons with end stage liver disease. Yet, utilization of LDLT has been limited in the United States (US).

Methods: In October 2021, the American Society of Transplantation held a consensus conference to identify important barriers to broader expansion of LDLT in the US, including data gaps, and make recommendations for impactful and feasible mitigation strategies to overcome these barriers. Domains addressed encompassed the entirety of the LDLT process. Representation from international centers and living donor kidney transplantation were included for their perspective/experience in addition to members across disciplines within the US liver transplantation community. A modified Delphi approach was employed as the consensus methodology.

Results: The predominant theme permeating discussion and polling results centered on culture; the beliefs and behaviors of a group of people perpetuated over time.

Conclusions: Creating a culture of support for LDLT in the US is key for expansion and includes engagement and education of stakeholders across the spectrum of the process of LDLT. A shift from awareness of LDLT to acknowledgement of benefit of LDLT is the primary goal. Propagation of the maxim "LDLT is the best option" is pivotal.

Keywords: consensus; liver transplantation; living donors.

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References

REFERENCES

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