Current Status of Living Donor Liver Transplantation: Impact, Advantages, and Challenges

Liu, Hao; Ashwat, Eishan; Humar, Abhinav

doi:10.1007/s11894-023-00882-9

Cited by 6 publications

(5 citation statements)

References 40 publications

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“…Liver transplant from living donors (LDLT) is an effective strategy to address the liver shortage issue [101,102], particularly in Asian countries where donation-after-brain-death systems are lacking. In the US, the utilization of LDLT has been low because of concerns regarding the recurrence of HCC and complications for the donor [103,104].…”

Section: Living Donor Liver Transplant (Ldlt)mentioning

confidence: 99%

“…Only recently has there been a consistent rise in LDLT for HCC in the United States. This increase indicates that the current system of allocating deceased donor livers cannot meet the demand (Figure 4, adapted from [102]).…”

Section: Living Donor Liver Transplant (Ldlt)mentioning

confidence: 99%

“…This increase indicates that the current system of allocating deceased donor livers cannot meet the demand ( Fig. 4 , adapted from Liu et al 102 ).…”

Section: Living Donor Liver Transplantmentioning

confidence: 99%

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Liver Transplantation for Hepatocellular Carcinoma: A Narrative Review and A Glimpse into The Future

Liu,

Sethi,

et al. 2024

Semin Liver Dis

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Liver transplantation (LT) is a highly effective treatment for carefully selected patients with hepatocellular carcinoma (HCC). In this review, we explored the development of LT selection criteria and organ allocation policies, comparing original data to underscore their historical progression into the intricate task of quantitatively estimating pre- and post-LT survivals. We emphasized the role of biomarkers such as serum AFP, DCP, circulating tumor cells, and circulating tumor DNA in predicting patient outcomes. Additionally, we examined the transplant-associated survival benefits and the difficulties in accurately calculating these benefits. We also reviewed recent advancements in targeted therapy and checkpoint inhibitors for advanced, inoperable HCC and projected their integration into liver transplantation for HCC. We further discussed the growing use of living donor liver transplants in the United States and compared its outcomes with those of deceased donor liver transplants. Furthermore, we examined the progress in machine perfusion techniques, which have shown potential in improving patient outcomes and enlarging the donor pool. These advancements present opportunities to enhance LT patient survivals, refine selection criteria, establish new priority metrics, develop innovative bridging and downstaging strategies, and formulate redesigned LT strategies for HCC treatments.

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Section: Living Donor Liver Transplant (Ldlt)mentioning

confidence: 99%

Section: Living Donor Liver Transplant (Ldlt)mentioning

confidence: 99%

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Liver Transplantation for Hepatocellular Carcinoma: A Narrative Review and A Glimpse into The Future

Liu,

Sethi,

et al. 2024

Semin Liver Dis

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“…The demand for LT is increasing; however, organs from deceased donors are limited, especially in specific regions, and living donor liver transplantation (LDLT) has become an alternative option [3]. LDLT offers a short waiting-list time and proper pre-LT treatment, which give oncologic advantages to HCC patients [4]. One of the most important factors to consider before performing LDLT is the safety of the living donors.…”

Section: Introductionmentioning

confidence: 99%

Clinical Factors Affecting the Rate of Liver Regeneration in Living Donors after Right Hepatectomy

Kim,

Suh,

Lee

et al. 2024

JPM

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Sufficient liver regeneration after a right hepatectomy is important in living donors for preventing postoperative hepatic insufficiency; however, it differs for each living donor so we investigated the clinical factors affecting the rate of liver regeneration after hepatic resection. This retrospective case–control study investigated fifty-four living donors who underwent a right hepatectomy from July 2015 to March 2023. Patients were classified into 2 groups by the remnant/total volume ratio (RTVR): Group A (RTVR < 30%, n = 9) and Group B (RTVR ≥ 30%, n = 45). The peak postoperative level of total bilirubin was more elevated in Group A than in Group B (3.0 ± 1.1 mg/dL vs. 2.3 ± 0.8 mg/dL, p = 0.046); however, no patients had hepatic insufficiency or major complications. The rates of residual liver volume (RLV) growth at Postoperative Week 1 (89.1 ± 26.2% vs. 53.5 ± 23.7%, p < 0.001) were significantly greater in Group A, and its significant predictors were RTVR (β = −0.478, p < 0.001, variance inflation factor (VIF) = 1.188) and intraoperative blood loss (β = 0.247, p = 0.038, VIF = 1.182). In conclusion, as the RLV decreases, compensatory liver regeneration after hepatic resection becomes more prominent, resulting in comparable operative outcomes. Further studies are required to investigate the relationship between hematopoiesis and the rate of liver regeneration.

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“…For patients with end-stage liver failure, the only definitive treatment is orthotopic liver transplantation (OLT), which has been the only therapeutic option since 1983. Nevertheless, the demand for OLT consistently outpaces the available supply of donor organs, leading to post-operative complications such as thrombosis, biliary disorders, graft rejection, and elevated morbidity and mortality rates among patients [4,5]. Therefore, much hope has shifted to alternative therapies that can prevent or reverse liver failure.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional cell-based strategies for liver regeneration

GUO,

XIA,

YANG

2024

BIOCELL

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Liver regeneration and the development of effective therapies for liver failure remain formidable challenges in modern medicine. In recent years, the utilization of 3D cell-based strategies has emerged as a promising approach for addressing these urgent clinical requirements. This review provides a thorough analysis of the application of 3D cellbased approaches to liver regeneration and their potential impact on patients with end-stage liver failure. Here, we discuss various 3D culture models that incorporate hepatocytes and stem cells to restore liver function and ameliorate the consequences of liver failure. Furthermore, we explored the challenges in transitioning these innovative strategies from preclinical studies to clinical applications. The collective insights presented herein highlight the significance of 3D cell-based strategies as a transformative paradigm for liver regeneration and improved patient care.

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Current Status of Living Donor Liver Transplantation: Impact, Advantages, and Challenges

Cited by 6 publications

References 40 publications

Liver Transplantation for Hepatocellular Carcinoma: A Narrative Review and A Glimpse into The Future

Liver Transplantation for Hepatocellular Carcinoma: A Narrative Review and A Glimpse into The Future

Clinical Factors Affecting the Rate of Liver Regeneration in Living Donors after Right Hepatectomy

Three-dimensional cell-based strategies for liver regeneration

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