The success rate of deceased donor liver transplantation is now high, with 1-year survival rates of 85% to 90% now being reported.1 However, the gap between recipients waiting for liver transplantation and available deceased donor organs appears to be widening. There is currently a waiting list of 17,267 people in the United States for liver transplants,2 and nearly 2,000 patients on the United Network for Organ Sharing waiting list died in 2001.3 The use of livers from living donors may increase the total number of livers available for transplantation.
Currently nearly 4,000 adult-to-child (AC) living donor liver transplants, and over 2,000 adult-to-adult (AA) living donor liver transplants, have been done worldwide. Data from the organ procurement and transplantation network in the United States2 shows that in the U.S. living donor liver transplantation (LDLT) represented 3.8% of all liver transplantations performed between 1988 and 2004. The most commonly used graft for AA LDLT is a right lobe. AA LDLT may therefore involve removal of up to 70% of the living donor's liver, one of the most invasive procedures that could be contemplated for healthy individuals.
While AA living donor liver transplantation outcomes may be similar to those for deceased donor transplantation for the recipients, there are concerns about donor morbidity, and some cases of donor deaths have been reported. To address this issue, we have undertaken a systematic review of safety and efficacy outcomes in AA living donor liver transplantation, and we present here the main findings of this review.