Living donor liver transplantation: techniques and results (original) (raw)

Living donor liver transplantation (LDLT) has been practiced for more than a decade, but until recently only the pediatric population realized the benefit of this large pool of organs. Right lobe donor resection has made it possible to routinely offer this alternative to adults, and the overwhelming demand for organs has motivated a substantial number of transplant centers to become involved with adult-to-adult LDLT. A reasonable level of donor safety has been demonstrated, and recipient results have been encouraging thus far. A wealth of experience has accumulated during the past few years, making it possible to begin to focus on the nuances specific to right lobe grafting. Efforts toward achieving optimal results have concentrated on the management of the hepatic veins and bile ducts, and the donor and recipient surgeries are evolving with these variables in mind. Other donor resections have been reported but have not gained widespread acceptance. Left sided liver resections and transplants are still routinely performed for children, and the surgical techniques have continued to evolve but not at the same pace. This review highlights the technical advances and considerations that have been reported and discussed during the past year, with particular emphasis on those pertinent to standard right lobe LDLT.