Should living donor liver transplantation be part of every liver transplant program?

Kadry, Zakiyah; Cormack, Lucas Mc; Clavien, Pierre Alain

doi:10.1016/j.jhep.2005.05.006

Cited by 10 publications

(5 citation statements)

References 33 publications

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“…The specific mechanisms for these observations are unclear, but our findings are in accordance with previous studies suggesting that LDLT should be reserved for high volume (at least 20-25 cases per year) centers to minimize morbidity and mortality. 11,14 This observation reinforces the concept that surgical volume is related to a decrease in surgical complications. From our data, we can also conclude that maintaining a high volume of yearly cases is also relevant to minimize complications.…”

Section: Discussionsupporting

confidence: 80%

“…To minimize the donor risk, it has been suggested that LDLT should be performed in high-volume centers with surgical expertise in both hepatobiliary surgery and DDLT. 11 In previous reports, the postoperative complication rate in living donors ranged from 9 to 40%, [12][13][14][15] with a mortality rate of 0.1 to 0.3%. 16,17 The most common surgical complications described after right lobe (RL) donation have been bleeding and biliary complications (i.e., leakage and/or stricture), whereas the most frequent medical issues after RL donation are respiratory complications (e.g., pleural effusion) and thromboembolic events.…”

mentioning

confidence: 99%

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Surgical Complications after Right Hepatectomy for Live Liver Donation: Largest Single-Center Western World Experience

et al. 2018

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The authors assessed the incidence, management, and risk factors for postoperative complications after right lobe (RL) live donor hepatectomy in a high-volume center in North America. All donors undergoing an RL live donor hepatectomy between 2000 and 2017 at our institution were included. The primary outcome was the development of complications (both medical and surgical). Predictors of postoperative complications were determined by logistic regression. A total of 587 patients underwent RL live donor hepatectomy. Among those, 187 postoperative complications were diagnosed in 141 (24%) patients. One patient had >90-day morbidity, and there were no donor deaths. Overall complications were significantly higher in the first era, 2000 to 2008 (81 [57.4%]) versus the second era, 2009 to 2017 (60 [42.6%]) ( = 0.01). On multivariate analysis, the only predictor of postoperative complications was the center volume of RL live donor hepatectomy in the previous 12 months with an odds ratio of 0.97 (95% confidence interval: 0.95-0.99). In conclusion, increasing center volume is associated with lower rates of postoperative complications after RL living liver donation.

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Section: Discussionsupporting

confidence: 80%

mentioning

confidence: 99%

Surgical Complications after Right Hepatectomy for Live Liver Donation: Largest Single-Center Western World Experience

et al. 2018

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“…The INCUCAI is the national entity controlling organ allocation and transplantation and must guarantee equal access to LT in our country. Despite the great medical effort expended to develop LT programmes in the country, citing the shortage of blood products, logistical problems or the non‐operability of an LT as official reasons for turning down a liver offer alerts us to the need for external monitoring of the quality of health care in this field 28 . National entities and medical societies should focus on developing and implementing specific regulations to ensure standards of excellence to provide the highest quality of patient care in the area of LT.…”

Section: Discussionmentioning

confidence: 99%

Rescue policy for discarded liver grafts: a single-centre experience of transplanting livers ‘that nobody wants’

McCormack

Quiñonez

Ríos³

et al. 2010

HPB

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“…The primary outcome is OS and the first results are planned to be published in 2020. Certainly the main concern when utilizing LD grafts is donor safety and therefore such approach needs to be conducted in high volume centers [ 66 , 67 ].…”

Section: Liver Graft Scarcity: Living-donor Liver Transplantation mentioning

confidence: 99%

The New Era of Transplant Oncology: Liver Transplantation for Nonresectable Colorectal Cancer Liver Metastases

Gorgen

Muaddi

McGilvray

et al. 2018

Canadian Journal of Gastroenterology and Hepatology

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Colorectal cancer (CRC) is the third most incident cancer worldwide. Most of CRC patients will develop distant metastases, mainly to the liver, and liver resection is the only potential chance for cure. On the other hand, only a small proportion of patients with hepatic CRC metastasis are candidates for upfront liver resection. Liver transplantation (LT) is an attractive option for patients with nonresectable CRC liver metastases (NRCLM) without extrahepatic involvement. Initial experiences with LT for NRCLM achieved very poor outcomes, with a 5-year overall survival (OS) lower than 20%. However, these initial studies did not have a standardized patient selection or neoadjuvant or adjuvant therapies. With recent advances in the surgical and medical oncology fields, the landscape has changed. Recent studies from Norway have shown an encouraging 5-year OS of 50% when transplanting patients with NRCLM. Nevertheless, the main concern when expanding the indications for LT is organ shortage. To manage this organ shortage, strategies utilizing live donor liver transplantation are gaining favor. A few ongoing trials are assessing the impact of LT in NRCLM patient survival. Therefore, the aim of this paper is to review the current status of LT for NRCLM.

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Should living donor liver transplantation be part of every liver transplant program?

Cited by 10 publications

References 33 publications

Surgical Complications after Right Hepatectomy for Live Liver Donation: Largest Single-Center Western World Experience

Surgical Complications after Right Hepatectomy for Live Liver Donation: Largest Single-Center Western World Experience

Rescue policy for discarded liver grafts: a single-centre experience of transplanting livers ‘that nobody wants’

The New Era of Transplant Oncology: Liver Transplantation for Nonresectable Colorectal Cancer Liver Metastases

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