Living-donor liver transplantation (LDLT) is one approach to reduce waiting list mortality. The technique of LDLT is standardized, but requires excellent expertise in the pre-, peri- and postoperative period. Until 2006, full-size postmortal liver transplantation was the standard technique at our centre. Since 09.11.2006, 23 LDLT were performed including 15 left-lateral segments in pediatric recipients (age 0.6 (0.2-9.7); 1.5 ± 2.3 years) and 8 right lobes in adult recipients (age 57.9 (17.7-69.5); 54.4 ± 16.0 years). The living donor graft was the donated by the father (n=11), the mother (n=4), a son (n=3), a cousin (n=2), a daughter (n=1), a nephew (n=1) and a son in law (n=1). Living donor selection criteria were: blood group compatibility, age < 60 years, body mass index < 30, steatosis < 10 % for adult and < 30 % for pediatric recipients, GRBWR > 0.7. Donor and recipient survival is 100 %, both after a median follow up of 271 (range: 7-601; Mean: 234.4 ± 163.0) days. Living-donor graft survival is 91.3 % after a median follow-up of 196 (range: 7-601; Mean: 217.4 ± 172.3) days. Two recipients required retransplantation due to hepatic artery thrombosis. One LDLT could not be performed; the donor operation was aborted due to biliary variation detected by intraoperative cholangiography. In Conclusion, a new LDLT-program can be safely implicated, if the standards are meticulously followed. However, the basics are a good functioning interdisciplinary transplant team and long-term surgical experience in hepatobiliary and transplantation surgery.
Volume : 6
Issue : 4
Pages : 120
Department of General- und Thoracic Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Germany