Live donor liver transplantation in New Zealand: a report on the first 20 cases.
BACKGROUND
Liver transplantation (LT) is established treatment for adults and children with acute or chronic liver failure, however there are insufficient donor organs to meet demand and 14% of New Zealand patients have died waiting or were de-listed due to deterioration whilst on the waiting list. Live donor liver transplantation (LDLT) offers an alternative graft source that enables timely transplantation, but also carries the risk of morbidity and mortality for the donor.


OBJECTIVE
To report the initial experience with LDLT in New Zealand.


METHODS
Review of donor and recipient outcomes for the first 20 cases.


RESULTS
129 potential live liver donors were assessed for 68 recipients. Donors were evaluated according to a multi-step protocol including independent donor advocacy. Twenty LDLT were performed on 7 adults and 13 paediatric recipients using 5 right lobe, 2 extended left lobe, 2 left lobe, and 11 left lateral section grafts. Five donors (25%) experienced postoperative complications, none of which were life-threatening. Four recipients had acute liver failure and 16 had chronic liver disease including one retransplant. There was a high rate of recipient biliary complications (40%) but graft and recipient survival is 100% to date.


CONCLUSIONS
LDLT has been successfully introduced in New Zealand with good donor and recipient outcomes.
McCall
John
J
Auckland City Hospital, New Zealand. johnmc@adhb.govt.nz
Johnston
Margaret
M
Harrison
Barry
B
Dittmer
Ian
I
Benjamin
Ron
R
Fullerton
Yvonne
Y
Holden
Andrew
A
Gunn
Kerry
K
Johnston
Peter
P
Gane
Ed
E
Orr
David
D
Chin
Simon
S
Evans
Helen
H
Mouat
Stephen
S
Munn
Stephen
S
D000328:Adult; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008107:Liver Diseases / Q000601:surgery; D016031:Liver Transplantation / Q000706:statistics & numerical data*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D011183:Postoperative Complications / Q000453:epidemiology; D009927:Tissue and Organ Procurement / Q000458:organization & administration; D016896:Treatment Outcome; D055815:Young Adult