Is There a Role for Living Donor Intestine Transplants?

Abstract

The use of living donors with intestinal transplantation is controversial because it may not significantly improve candidate access to organs when intestine-only grafts are needed, and may involve excessive donor risk when combined liver-intestine grafts are required. Although limited data are available for comparison at this time, graft and patient survival rates for intestinal transplantations using living donors are no different than for deceased donor transplantations. Potential benefits that may be provided to the intestine transplant recipient through the use of living donors include better HLA matching, shorter ischemia times, better bowel preparation, and better opportunities for introducing immunomodulatory strategies. Conversely, living intestine donors are at risk for mortality, significant morbidity, financial loss, and psychologic trauma. The long-term outcomes of living intestine donors have not yet been reported. Ultimately, these data are essential before the wider use of living donors can be advocated for intestinal transplantation.

Intestinal failure: a viable proposition in India

“…Use of living donors makes the transplant an elective procedure with minimal waiting and cold ischemia times and allows HLA matching. Further, the desire to help a suffering member of the family, particularly for parents donating to their sick child confers psychological benefit even though they do not undergo an operation to improve their own health [2]. Factors such as size match are not as crucial in LDIT as in cadaver transplant, where a donor that is 50 % to 75 % of the size of the recipient is usually preferred, owing to multiple prior laparotomies, adhesions and loss of abdominal wall in the recipient.…”