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Living Donor Liver Transplantation

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Liver and Biliary Tract Surgery

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Abstract

The disparity between organ demand and the cadaveric donor supply for children resulted initially in a pre-transplant mortality of around 25% and was disproportionately high compared with adult patients [1]. The problem of size mismatch and the different epidemiology of pediatric donorship and terminally diseased children was chiefly responsible for that situation [2]. This stimulated the development of technical innovations, based on the segmental anatomy of the liver, which facilitated transplanting parts of large deceased donor livers into smaller recipients

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References

  1. Malago M, Rogiers X, Broelsch CE. Redused-size hepatic allografts. Annu Rev Med 1995; 46:507–12.

    Article  PubMed  CAS  Google Scholar 

  2. Emond JC, Whitington PF, Thistlethwaite JR, Alonso EM, Broelsch CE. Reduced-size orthotopic liver transplantation: use in the management of children with chronic liver disease. Hepatology 1989; 10:867–72.

    Article  PubMed  CAS  Google Scholar 

  3. Bismuth H, Houssin D. Reduced-sized orthotopic liver graft in hepatic transplantation in children. Surgery. 1984; 95:367–70.

    PubMed  CAS  Google Scholar 

  4. Broelsch CE, Emond JC, Thistlethwaite JR, Rouch DA, Whitington PF, Lichtor JL. Liver transplantation with reduced-size donor organs. Transplantation 1988; 45:519–24.

    Article  PubMed  CAS  Google Scholar 

  5. Broelsch CE, Emond JC, Thistlethwaite JR, Whitington PF, Zucker AR, Baker AL, Aran PF, Rouch DA, Lichtor JL. Liver transplantation, including the concept of reduced-size liver transplants in children. Ann Surg. 1988; 208:410–20.

    Article  PubMed  CAS  Google Scholar 

  6. Otte JB. Is it right to develop living related liver transplantation? Do reduced and split livers not suffice to cover the needs? Transpl Int 1995; 8:69–73.

    Article  PubMed  CAS  Google Scholar 

  7. Otte JB, de Ville de Goyet J, Sokal E, Alberti D, Moulin D, de Hemptinne B, et al. Size reduction of the donor liver is a safe way to alleviate the shortage of size-matched organs in pediatric liver transplantation. Ann Surg. 1990; 211:146–57.

    Article  PubMed  CAS  Google Scholar 

  8. Pichlmayr R. Technical developments in liver transplantation. Baillieres Clin Gastroenterol 1989; 3757–65.

    Google Scholar 

  9. Pichlmayr R, Ringe B, Gubernatis G, Hauss J, Bunzendahl H. [Transplantation of a donor liver to 2 recipients (splitting transplantation) — a new method in the further development of segmental liver transplantation]. Langenbecks Arch Chir 1988; 373:127–30.

    Article  PubMed  CAS  Google Scholar 

  10. Broelsch CE, Emond JC, Whitington PF, Thistlethwaite JR, Baker AL, Lichtor JL. Application of reduced-size liver transplants as split grafts, auxiliary orthotopic grafts, and living related segmental transplants. Ann Surg 1990; 212: 368–75.

    Article  PubMed  CAS  Google Scholar 

  11. Emond JC, Whitington PF, Thistlethwaite JR, Cherqui D, Alonso EA, Woodle IS, Vogelbach P, Busse-Henry SM, Zucker AR, Broelsch CE. Transplantation of two patients with one liver. Analysis of a preliminary experience with “split-liver” grafting. Ann Surg 1990; 212:14–22.

    Article  PubMed  CAS  Google Scholar 

  12. Broelsch CE, Whitington PF, Emond JC, Heffron TG, Thistlethwaite JR, Stevens L, Piper J, Whitington SH, Lichtor JL. Liver transplantation in children from living related donors. Surgical techniques and results. Ann Surg 1991; 214: 428–37.

    Article  PubMed  CAS  Google Scholar 

  13. Guarrera JV, Emond JC. Advances in segmental liver transplantation: can we solve the donor shortage? Transplant Proc 2001; 33:3451–5.

    Article  PubMed  CAS  Google Scholar 

  14. Karbe T, Kutemeier R, Rogiers X, Malago M, Kuhlencordt R, Broelsch CE. Logistical aspects and procedures in split-liver transplantation. Transplant Proc 1996; 28:43–4.

    PubMed  CAS  Google Scholar 

  15. Raia S, Nery JR, Mies S. Liver transplantation form live donors. Lancet 1989; 2:497.

    Article  PubMed  CAS  Google Scholar 

  16. Strong R, Ong TH, Pillay P, Wall D, Balderson G, Lynch S. A new method of segmental orthotopic liver transplantation in children. Surgery 1988; 104:104–7.

    PubMed  CAS  Google Scholar 

  17. Broelsch CE, Whitington PF, Emond JC, Heffron TG, Thistrlethwaite JR, Stevens L, et al. Liver transplantation in children from living related donors. Annals of Surgery 1991; 214:428–39.

    Article  PubMed  CAS  Google Scholar 

  18. Tanaka K, Uemoto S, Tokunaga Y, Fujita S, Sano K, Nishizawa T, Sawada H, Shirahase I, Kim HJ, Yamaoka Y, et al. Surgical techniques and innovations in living related liver transplantation. Ann Surg 1993; 217:82–91.

    Article  PubMed  CAS  Google Scholar 

  19. Marcos A, Fisher RA, Ham JM, Shiffman ML, Sanyal AJ, Luketic VA, Sterling RK, Posner MP. Right lobe living donor liver transplantation. Transplantation 1999; 68:798–803.

    Article  PubMed  CAS  Google Scholar 

  20. Yamaoka Y, Washida M, Honda K, Tanaka K, Mori K, Shimahara Y, Okamoto S, Ueda M, Hayashi M, Tanaka A, et al. Liver transplantation using a right lobe graft from a living related donor. Transplantation 1994; 57:1127–30.

    Article  PubMed  CAS  Google Scholar 

  21. Data from the United Network for Organ Sharing. http://www.optn.org/latestData/rptData.asp.

  22. Broelsch CE, Frilling A, Malago M. Should we expand the criteria for liver transplantation for hepatocellular carcinomayes, of course! J Hepatol 2005; 43:569–573.

    Article  PubMed  Google Scholar 

  23. Nadalin S, Malago M, Valentin-Gamazo C et al. Preoperative donor liver biopsy for adult living donor liver transplantation: risks and benefits. Liver Transpl 2005; 11:980–986.

    Article  PubMed  Google Scholar 

  24. Valentin-Gamazo C, Malago M, Karliova M et al. Experience after the evaluation of 700 potential donors for living donor liver transplantation in a single center. Liver Transpl 2004; 10:1087–96.

    Article  PubMed  Google Scholar 

  25. Pascher A, Sauer IM, Walter M et al. Donor evaluation, donor risks, donor outcome, and donor quality of life in adult-to-adult living donor liver transplantation. Liver Transpl 2002; 8:829–837.

    Article  PubMed  Google Scholar 

  26. Sugawara Y, Makuuchi M. Technical advances in living-related liver transplantation. J Hepatobiliary Pancreat Surg 1999; 6:245–253.

    Article  PubMed  CAS  Google Scholar 

  27. Malago M, Rogiers X, Broelsch CE. Liver splitting and living donor techniques. Br Med Bull. 1997; 53(4):860–7.

    PubMed  CAS  Google Scholar 

  28. Tanaka K, Uemoto S, Tokunaga Y, Fujita S, Sano K, Nishizawa T, Sawada H, Shirahase I, Kim HJ, Yamaoka Y, et al. Surgical techniques and innovations in living related liver transplantation. Ann Surg. 1993 Jan; 217(1):82–91.

    Article  PubMed  CAS  Google Scholar 

  29. Fan ST, Lo CM, Liu CL. Technical refinement in adult-to-adult living donor liver transplantation using right lobe graft. Ann Surg. 2000 Jan; 231(1):126–31.

    Article  PubMed  CAS  Google Scholar 

  30. Marcos A, Ham JM, Fisher RA, Olzinski AT, Posner MP. Single center analysis of the first 40 adult-to-adult living donor liver transplants using the right lobe. Liver Transpl. 2000 May; 6(3):296–301.

    Article  PubMed  CAS  Google Scholar 

  31. Broelsch CE, Malago M, Testa G, Valentin Gamazo C. Living donor liver transplantation in adults: outcome in Europe. Liver Transpl. 2000 Nov; 6(6 Suppl 2):S64–5.

    Article  PubMed  CAS  Google Scholar 

  32. Fan ST, Yong BH, Lo CM, Liu CL, Wong J. Right lobe living donor liver transplantation with or without venovenous bypass. Br J Surg. 2003 Jan; 90(1):48–56.

    Article  PubMed  CAS  Google Scholar 

  33. Malago M, Testa G, Frilling A, Nadalin S, Valentin-Gamazo C, Paul A, Lang H, Treichel U, Cicinnati V, Gerken G, Broelsch CE. Right living donor liver transplantation: an option for adult patients: single institution experience with 74 patients. Ann Surg. 2003 Dec; 238(6):853–62.

    Article  PubMed  Google Scholar 

  34. Radtke A, Schroeder T, Molmenti EP, Sotiropoulos GC, Schenk A, Paul A, Frilling A, Lang H, Nadalin S, Peitgen HO, Broelsch CE, Malago M. natomical and physiological comparison of liver volumes among three frequent types of parenchyma transection in live donor liver transplantation. Hepatogastroenterology. 2005 Mar–Apr; 52(62):333–8.

    PubMed  Google Scholar 

  35. Radtke A, Schroeder T, Sotiropoulos GC, Molmenti E, Schenk A, Paul A, Nadalin S, Lang H, Saner F, Peitgen HO, Broelsch CE, Malago M. Anatomical and physiological classification of hepatic vein dominance applied to liver transplantation. Eur J Med Res. 2005 May 20; 10(5):187–94.

    PubMed  CAS  Google Scholar 

  36. Malago M, Molmenti EP, Paul A, Nadalin S, Lang H, Radtke A, Liu C, Frilling A, Biglarnia R, Broelsch CE. Hepatic venous outflow reconstruction in right live donor liver transplantation. Liver Transpl. 2005 Mar; 11(3):364–5.

    Article  PubMed  Google Scholar 

  37. Fan ST, Lo CM, Liu CL, Yong BH, Chan JK. Split liver transplantation for two adult recipients. Hepatogastroenterology. 2003 Jan–Feb; 50(49):231–4.

    PubMed  Google Scholar 

  38. Scatton O, Belghiti J, Dondero F, Goere D, Sommacale D, Plasse M, Sauvanet A, Farges O, Vilgrain V, Durand F. Harvesting the middle hepatic vein with a right hepatectomy does not increase the risk for the donor. Liver Transpl. 2004 Jan; 10(1):71–6.

    Article  PubMed  Google Scholar 

  39. Kim BS, Kim TK, Kim JS, Lee MG, Kim JH, Kim KW, Sung KB, Kim PN, Ha HK, Lee SG, Kang W. Hepatic venous congestion after living donor liver transplantation with right lobe graft: two-phase CT findings. Radiology. 2004 Jul; 232(1):173–80.

    Article  PubMed  Google Scholar 

  40. Reddy K, Mallett S, Peachey T. Venovenous bypass in orthotopic liver transplantation: time for a rethink? Liver Transpl. 2005 Jul; 11(7) 741–9.

    Article  PubMed  Google Scholar 

  41. Malago M, Hertl M, Testa G, Rogiers X, Broelsch CE Split-liver transplantation: future use of scarce donor organs. World J Surg. 2002 Feb; 26(2):275–82.

    Article  PubMed  Google Scholar 

  42. Malago M, Testa G, Hertl M, Lang H, Paul A, Frilling A, Treichel U, Broelsch CE. Biliary reconstruction following right adult living donor liver transplantation end-to-end or end-to-side duct-to-duct anastomosis. Langenbecks Arch Surg. 2002 Apr; 387(1):37–44.

    Article  PubMed  Google Scholar 

  43. Testa G, Malago M, Valentin-Gamazo C, Lindell G, Broelsch CE. Biliary anastomosis in living related liver transplantation using the right liver lobe: techniques and complications. Liver Transpl. 2000 Nov; 6(6) 710–4.

    Article  PubMed  CAS  Google Scholar 

  44. Troisi R, de Hemptinne B. Clinical relevance of adapting portal vein flow in living donor liver transplantation in adult patients. Liver Transpl. 2003 Sep; 9(9):S36–41.

    Article  PubMed  Google Scholar 

  45. Boillot O, Dawahra M, Mechet I, Poncet G, Choucair A, Henry L, Boucaud C, Sagnard P, Scoazec JY. Liver transplantation using a right liver lobe from a living donor. Transplant Proc. 2002 May; 34(3) 773–6.

    Article  PubMed  CAS  Google Scholar 

  46. Boillot O, Delafosse B, Mechet I, Boucaud C, Pouyet M. Small-for-size partial liver graft in an adult recipient; a new transplant technique. Lancet. 2002 Feb 2; 359(9304):406–7.

    Article  PubMed  Google Scholar 

  47. Troisi R, Ricciardi S, Smeets P, Petrovic M, Van Maele G, Colle I, Van Vlierberghe H, de Hemptinne B. Effects of hemi-portocaval shunts for inflow modulation on the outcome of small-for-size grafts in living donor liver transplantation. Am J Transplant. 2005 Jun; 5(6):1397–404.

    Article  PubMed  Google Scholar 

  48. Broelsch CE, Frilling A, Testa G et al. Living donor liver transplantation in adults. Eur J Gastroenterol Hepatol 2003; 15:3–6.

    Article  PubMed  Google Scholar 

  49. Sugawara Y, Makuuchi M. Living donor liver transplantation: present status and recent advances. Br Med Bull 2005; 75–76: 15–28.

    PubMed  Google Scholar 

  50. Beavers KL, Sandier RS, Shrestha R. Donor morbidity associated with right lobectomy for living donor liver transplantation to adult recipients. Liver Transpl 2002: 8:110–117.

    Article  PubMed  Google Scholar 

  51. Sugawara Y, Makuuchi M. Technical advances in living-related liver transplantation. J Hepatobiliary Pancreat Surg 1999; 6:245–253.

    Article  PubMed  CAS  Google Scholar 

  52. Mazzaferro V, Regalia E, Doci R et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 1996; 334:693–699.

    Article  PubMed  CAS  Google Scholar 

  53. Yao FY, Kinkhabwala M, LaBerge JM et al. The impact of pre-operative loco-regional therapy on outcome after liver transplantation for hepatocellular carcinoma. Am J Transplant 2005; 5(4Pt 1) 795–804.

    Article  PubMed  Google Scholar 

  54. Yao FY, Ferrell L, Bass NM et al. Liver transplantation for hepatocellular carcinoma: expansion of the tumor size limits does not adversely impact survival. Hepatology 2001; 33:1394–1403.

    Article  PubMed  CAS  Google Scholar 

  55. Marrero JA, Fontana RJ, Barrat A et al. Prognosis of hepatocellular carcinoma: comparison of 7 staging systems in an American cohort. Hepatology 2005; 41:707–716.

    Article  PubMed  Google Scholar 

  56. Kawasaki S, Makuuchi M, Matsunami H et al. Living related liver transplantation in adults. Ann Surg 1998; 227:269–274.

    Article  PubMed  CAS  Google Scholar 

  57. Sotiropoulos GC, Malago M, Molmenti E, et al. Liver transplantation for hepatocellular carcinoma in cirrhosis: is clinical tumor classification before transplantation realistic? Transplantation 2005; 79:483–487.

    Article  PubMed  Google Scholar 

  58. Sotiropoulos GC, Malago M, Molmenti EP, Paul A, Nadalin S, Brokalaki E, et al. Liver transplantation and incidentally found hepatocellular carcinoma in liver explants: need for a new definition? Transplantation 2006; 81:531–535.

    Article  PubMed  Google Scholar 

  59. Marsh JW, Dvorchik I. Liver organ allocation for hepatocellular carcinoma: are we sure? Liver Transpl 2003; 9:693–696.

    Article  PubMed  Google Scholar 

  60. Bruix J, Llovet JM. Prognostic prediction and treatment strategy in hepatocellular carcinoma. Hepatology 2002; 35: 519–524.

    Article  PubMed  Google Scholar 

  61. Cheng SJ, Pratt DS, Freeman RB Jr et al. Living-donor versus cadaveric liver transplantation for non-resectable small hepatocellular carcinoma and compensated cirrhosis: a decision analysis. Transplantation 2001; 72:861–868.

    Article  PubMed  CAS  Google Scholar 

  62. Hwang S, Lee SG, Joh JW, Suh KS, Kim DG. Liver transplantation for adult patients with hepatocellular carcinoma in Korea: comparison between cadaveric donor and living donor liver transplantations. Liver Transpl 2005; 11:1265–1272.

    Article  PubMed  Google Scholar 

  63. Todo S, Furukawa H; Japanese Study Group on Organ Transplantation. Living donor liver transplantation for adult patients with hepatocellular carcinoma: experience in Japan. Ann Surg 2004; 240:451–459.

    Article  PubMed  Google Scholar 

  64. Malago M, Sotiropoulos GC, Nadalin S, Valentin-Gamazo C, Paul A, Lang H, et al. Living donor liver transplantation for hepatocellular carcinoma: A single-center preliminary report. Liver Transpl 2006; 12:934–940.

    Article  PubMed  Google Scholar 

  65. Leung JY, Zhu AX, Gordon FD, et al. Liver transplantation outcomes for early-stage hepatocellular carcinoma: results of a multicenter study. Liver Transpl 2004; 10:1343–1354.

    Article  PubMed  Google Scholar 

  66. Kneteman NM, Oberholzer J, Al Saghier M, et al. Sirolimusbased immunosuppression for liver transplantation in the presence of extended criteria for hepatocellular carcinoma. Liver Transpl 2004; 10:1301–1311.

    Article  PubMed  Google Scholar 

  67. Vivarelli M, Cucchetti A, Piscaglia F, et al. Analysis of risk factors for tumor recurrence after liver transplantation for hepatocellular carcinoma: key role of immunosuppression. Liver Transpl 2005; 11:497–503.

    Article  PubMed  Google Scholar 

  68. Caplan AL. Proceed with caution: live living donation of lobes of liver for transplantation. Liver Transpl. 2001 Jun; 7(6):494–5.

    Article  PubMed  CAS  Google Scholar 

  69. Shiffman ML, Brown RS Jr, Olthoff KM, Everson G, Miller C, Siegler M, Hoofnagle JH. Living donor liver transplantation: summary of a conference at The National Institutes of Health. Liver Transpl. 2002 Feb; 8(2):174–88.

    Article  PubMed  Google Scholar 

  70. Malago M, Testa G, Marcos A, Fung JJ, Siegler M, Cronin DC, Broelsch CE. Ethical considerations and rationale of adult-to-adult living donor liver transplantation. Liver Transpl. 2001 Oct; 7(10):921–7.

    Article  PubMed  CAS  Google Scholar 

  71. Miwa S, Hashikura Y, Mita A, Kubota T, Chisuwa H, Nakazawa Y, Ikegami T, Terada M, Miyagawa S, Kawasaki S. Living-related liver transplantation for patients with fulminant and subfulminant hepatic failure. Hepatology. 1999 Dec; 30(6): 1521–6.

    Article  PubMed  CAS  Google Scholar 

  72. Lo CM, Fan ST, Liu CL, Wei WI, Chan JK, Lai CL, Lau GK, Wong J. Applicability of living donor liver transplantation to high-urgency patients. Transplantation. 1999 Jan 15; 67(1): 73–7.

    Article  PubMed  CAS  Google Scholar 

  73. Northup PG, Berg CL. Living donor liver transplantation: the historical and cultural basis of policy decisions and ongoing ethical questions. Health Policy. 2005 May; 72(2):175–85.

    Article  PubMed  Google Scholar 

  74. Trotter JF. Living donor liver transplantation: is the hype over? J Hepatol. 2005 Jan; 42(1):20–5.

    Article  PubMed  Google Scholar 

  75. Karliova M, Malago M, Valentin-Gamazo C, Reimer J, Treichel U, Franke GH, Nadalin S, Frilling A, Gerken G, Broelsch CE. Living-related liver transplantation from the view of the donor: a 1-year follow-up survey. Transplantation. 2002 Jun 15; 73(11):1799–804.

    Article  PubMed  Google Scholar 

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Editor information

Editors and Affiliations

  1. 2nd Surgical Department and Surgical Oncology Unit, Red Cross Hospital, Athens, Greece

    Constantine Ch. Karaliotas MD, PhD (Chairman) (Chairman)

  2. Department of General Surgery and Transplantation, University Clinic Essen, Germany

    Christoph E. Broelsch MD, FACS (Professor and Chairman) (Professor and Chairman)

  3. Hepatobiliary Surgery, Imperial College, Hammersmith Hospital, London, UK

    Nagy A. Habib ChM, FRCS (Professor) (Professor)

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(2006). Living Donor Liver Transplantation. In: Karaliotas, C.C., Broelsch, C.E., Habib, N.A. (eds) Liver and Biliary Tract Surgery. Springer, Vienna. https://doi.org/10.1007/978-3-211-49277-2_50

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  • DOI: https://doi.org/10.1007/978-3-211-49277-2_50

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