title: Living donor liver transplantation in adults in the MELD era in Germany--a multi-center retrospective analysis.
abstract: The aim of this analysis was to provide an update on the current trend in living donor liver transplantation (LDLT) for adult recipients in the model of end stage liver disease (MELD) era in Germany and to encourage a wider implementation of LDLT. We descriptively analysed the data of LDLTs in Germany from 15 December 2006 to 31 December 2009 using a multi-center retrospective analysis via a questionnaire and data provided by Eurotransplant. Ten German centers performed LDLTs in adults. Eighty four transplantations in 50 male recipients and 34 female recipients were performed during the review period, ranging from 1 to 16 LDLTs per center. Hepatocellular carcinoma in cirrhosis (15/84) was the most common transplantation indication. The recipient mean lab-MELD score was 15 (±8). Six re-transplantations were necessary after initial LDLTs. The 1-year patient survival was 81%. We obtained data of 79/84 donors. The incidence of complications was 30.4% (n = 24). There were no grade 5 complications according to the Clavien classification. LDLT is an established treatment option that may reduce the waiting time, provides high quality split liver grafts and should be advocated in the MELD era to reduce organ shortage and 'death on the waiting list'.
authors.affiliation: Department of General, Visceral and Vascular Surgery, University Hospital Jena, Erlanger Allee 101, Jena, Germany. settmacher@med.uni-jena.de
authors.forename: Utz
authors.initials: U
authors.lastname: Settmacher
authors.forename: Max
authors.initials: M
authors.lastname: Götz
authors.forename: Axel
authors.initials: A
authors.lastname: Rahmel
authors.forename: Erik
authors.initials: E
authors.lastname: Bärthel
authors.forename: Hans
authors.initials: H
authors.lastname: Schlitt
authors.forename: Gero
authors.initials: G
authors.lastname: Puhl
authors.forename: Dieter
authors.initials: D
authors.lastname: Broering
authors.forename: Frank
authors.initials: F
authors.lastname: Lehner
authors.forename: Lutz
authors.initials: L
authors.lastname: Fischer
authors.forename: Andreas
authors.initials: A
authors.lastname: Paul
authors.forename: Jan
authors.initials: J
authors.lastname: Schmidt
authors.forename: Silvio
authors.initials: S
authors.lastname: Nadalin
authors.forename: Aiman
authors.initials: A
authors.lastname: Obed
authors.forename: Michael
authors.initials: M
authors.lastname: Heise
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D058625:End Stage Liver Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery; D008113:Liver Neoplasms / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data*; D019520:Living Donors / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014850:Waiting Lists / Q000401:mortality