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Semin Liver Dis 2012; 32(04): 333-340
DOI: 10.1055/s-0032-1329900
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Living-Donor Liver Transplantation: Current Perspective

Steven Lobritto
1   Department of Pediatrics and Internal Medicine, NY Presbyterian Hospital–Morgan Stanley Children's Hospital, Columbia University Medical Center, New York, New York
,
Tomoaki Kato
2   Department of Surgery, NY Presbyterian Hospital, Columbia University Medical Center, New York, New York
,
Jean Emond
2   Department of Surgery, NY Presbyterian Hospital, Columbia University Medical Center, New York, New York
› Author Affiliations
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Publication History

Publication Date:
08 February 2013 (online)

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Abstract

The disparity between the number of available deceased liver donors and the number of patients awaiting transplantation continues to be an ongoing issue predisposing to death on the liver transplant waiting list. Deceased donor shortage strategies including the use of extended donor-criteria deceased donor grafts, split liver transplants, and organs harvested after cardiac death have fallen short of organ demand. Efforts to raise donor awareness are ongoing, but the course has been arduous to date. Living donor transplantation is a means to access an unlimited donor organ supply and offers potential advantages to deceased donation. Donor safety remains paramount demanding improvements and innovations in both the donor and recipient operations to ensure superior outcomes. The specialty operation is best preformed at centers with specific expertise and shuttling of select patients to these centers supported by third party payers is critical. Training future surgeons at centers with this specific experience can help disseminate this technology to improve local availability. Ongoing research in immunosuppression minimization, withdrawal and tolerance induction may make living donation a desired first-line operation rather than a necessary albeit less-desirable option. This chapter summarizes the progress of living liver donation and its potential applications.

Keywords

living donation - liver transplantation
 

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