Adult living donor liver transplantation: living donation of the right liver lobe.
BACKGROUND
Adult living donor liver transplantation (LDLT) has become a routine treatment option for patients waiting for liver transplantation. In European and North American countries, LDLT for adult recipients is mainly performed with right lobe grafts. Indications, when compared to deceased donor liver transplantation, are controversial.


METHODS
In our institution, patients suffering from hepatocellular carcinoma in cirrhosis, non-resectable hilar cholangiocarcinoma, viral hepatitis associated cirrhosis, as well as cholestatic liver and biliary disease are considered good candidates for LDLT.


RESULTS
In this overview, donor evaluation, graft selection, and the donor operation with special regard to operative techniques and strategies are discussed. For visualization, a 5-min video sequence of the standard donor operation as performed in our institution is attached.


CONCLUSIONS
Given the ongoing shortage of donor organs, adult LDLT has become a routine treatment option for patients waiting for liver transplantation. The associated inevitable risk for the healthy donor, however, remains ethically controversial.
Mittler
J
J
Department of General, Visceral and Transplant Surgery, Charité-Campus Virchow Klinikum, Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. jens.mittler@charite.de
Pascher
A
A
Jonas
S
S
Pratschke
J
J
Neumann
U P
UP
Langrehr
J M
JM
Neuhaus
P
P
D000328:Adult; D001650:Bile Duct Neoplasms / Q000601:surgery; D001653:Bile Ducts, Intrahepatic; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D018281:Cholangiocarcinoma / Q000601:surgery; D046148:Donor Selection / Q000379:methods; D006498:Hepatectomy / Q000379:methods; D006525:Hepatitis, Viral, Human / Q000601:surgery; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000601:surgery; D017093:Liver Failure / Q000209:etiology / Q000601:surgery*; D008113:Liver Neoplasms / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D011379:Prognosis; D020858:Tissue and Organ Harvesting / Q000379:methods