Live liver donation: a prospective analysis of exclusion criteria for healthy and potential donors.
BACKGROUND
Living donor liver transplantation represents a controversial option to increase the donor pool.


METHODS
Prospective and descriptive clinical study.


OBJECTIVE
(1) To identify risk factors (exclusion criteria) for live donation; (2) to determine the rate of recipients that benefit from a living donor.


METHODS
Between May 1995 (first adult-to-adult living donor liver transplantation in Spain) and November 2002, we evaluated 74 healthy volunteers and performed 12 living donor liver transplants (no donor mortality).


RESULTS
All actual donors and volunteers are alive and healthy. After a mean time of 3.2+/-0.5 weeks, 72% of potential donors were considered unsuitable for live donation. Exclusion criteria were grouped in three categories: (primary) donor safety reasons (68%); (secondary): ABO mismatch (17%) and (tertiary): cadaveric graft transplantation (15%). Consequently, just 43.7% of the recipients presenting to us with a potential living donor, did finally benefit from these organs. The mortality rate was 8.3% for 43 recipients presenting with a living donor in comparison to 15% for those who did not (321 recipients between May 1995 and November 2001).


CONCLUSIONS
ALDLT can benefit a significant number of recipients on the waiting list (43.7% of those presenting with a donor). The most frequent exclusion criteria concern donor safety, namely, unsuspected chronic liver diseases and unsuspected thrombophilic disorders.
Moreno Gonzalez
E
E
Hospital Universitario, Service of General, Digestive and Abdominal Organs Transplantation, University Hospital, 28109 Madrid, Spain.
Meneu Diaz
J C
JC
Garcia Garcia
I
I
Loinaz Segurola
C
C
Jimenez
C
C
Gomez
R
R
Abradelo
M
M
Moreno Elola
A
A
Jimenez
S
S
Ferrero
E
E
Calvo
J
J
Manrique
A
A
Herrero
M L
ML
D000017:ABO Blood-Group System; D000328:Adult; D001787:Blood Group Incompatibility; D002102:Cadaver; D006801:Humans; D008099:Liver; D016031:Liver Transplantation / Q000502:physiology*; D019520:Living Donors / Q000706:statistics & numerical data*; D018579:Patient Selection; D011446:Prospective Studies; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012449:Safety
D000017:ABO Blood-Group System