title: Recent advance in living donor liver transplantation.
abstract: Living donor liver transplantation (LDLT)has been performed in more than 2000 cases around the world. This procedure is considered to have certain advantages over cadaveric liver transplantation, because detailed preoperative evaluation of the donor liver is possible and superior graft quality is available. The indication has recently been widened to include adult patients. The results of LDLT have been reported to be very good. In this article,several considerations on LDLT,including living donor selection and application to adult patients, are discussed. Between June 1990 and March 2001, 143 patients underwent LDLT at Shinshu University Hospital. During this period, 160 patients were determined to be candidates for liver transplantation in our institution, and 185 candidates were evaluated as potential donors for these patients. Thirty-eight of 185 donor candidates were excluded for reasons including liver dysfunction and withdrawal of consent. The recipients included 60 adults, 50 (83%) of whom are currently alive. Taking into account the worldwide shortage of cadaveric organ donation,the importance of LDLT will probably never diminish. This procedure should be established on the basis of profound consideration of donor safety as well as accumulated expertise of hepatobiliary surgery.
authors.affiliation: First Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Hashikura
authors.forename: Seiji
authors.initials: S
authors.lastname: Kawasaki
authors.forename: Shinichi
authors.initials: S
authors.lastname: Miyagawa
authors.forename: Masaru
authors.initials: M
authors.lastname: Terada
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ikegami
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Nakazawa
authors.forename: Koichi
authors.initials: K
authors.lastname: Urata
authors.forename: Hisanao
authors.initials: H
authors.lastname: Chisuwa
authors.forename: Shiro
authors.initials: S
authors.lastname: Ogino
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Makuuchi
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006084:Graft Rejection; D006801:Humans; D007258:Informed Consent; D017114:Liver Failure, Acute / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality / Q000639:trends*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications; D016019:Survival Analysis; D016896:Treatment Outcome