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Living donor liver transplants: potential disadvantages
Author(s) -
HUMAR ABHINAV
Publication year - 2004
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2004.03692.x
Subject(s) - medicine , donation , living donor liver transplantation , liver transplantation , complication , surgery , adverse effect , transplantation , intensive care medicine , economics , economic growth
Living donor liver transplants (LDLTs) have provided many patients with a lifesaving option. Yet this option remains a significant undertaking, with potentially serious consequences for both the donor and the recipient. The donor is obviously the individual with the most to lose. The exact risks to the donor are difficult to quantify because reporting adverse donor events is not mandatory and no registry exists. The risk to the donor also depends on the extent of the donor resection. By some estimates, the risk of donor mortality is 0.3% to 1.0%. The reported risk of donor complications varies greatly in the literature—ranging from 5 to 60%. Reported complications are usually short‐term complications, since most donors are not followed by the transplant center after the first year. Very few studies have examined other issues that are important for the donor, such as the quality of life after donation, the time to full recovery, and the financial impact of donation. For the recipient, an LDLT is a lifesaving procedure. Especially in countries where deceased donation is scarce, the benefits of an LDLT for the recipient are obvious. However, analysis of national data from the United States demonstrates that, at least for adults, results of an LDLT may be inferior, as compared with a whole‐liver transplant from a deceased donor. Moreover, the surgical complication rate after an LDLT is significantly higher. As LDLTs continue to gain in popularity, careful evaluation and re‐evaluation of both donor and recipient outcomes are necessary to optimize results.