title: Outcomes of patients with benign liver diseases undergoing living donor versus deceased donor liver transplantation.
abstract: OBJECTIVE
  The number of people undergoing living donor liver transplantation (LDLT) has increased rapidly in many transplant centres. Patients considering LDLT need to know whether LDLT is riskier than deceased donor liver transplantation (DDLT). The aim of this study was to compare the outcomes of patients undergoing LDLT versus DDLT.
  
  
  METHODS
  A total of 349 patients with benign liver diseases were recruited from 2005 to 2011 for this study. LDLT was performed in 128 patients, and DDLT was performed in 221 patients. Pre- and intra-operative variables for the two groups were compared. Statistically analysed post-operative outcomes include the postoperative incidence of complication, biliary and vascular complication, hepatitis B virus (HBV) recurrence, long-term survival rate and outcomes of emergency transplantation.
  
  
  RESULTS
  The waiting times were 22.10±15.31 days for the patients undergoing LDLT versus 35.81±29.18 days for the patients undergoing DDLT. The cold ischemia time (CIT) was 119.34±19.75 minutes for the LDLT group and 346±154.18 for DDLT group. LDLT group had higher intraoperative blood loss, but red blood cell (RBC) transfusion was not different. Similar ≥ Clavien III complications, vascular complications, hepatitis B virus (HBV) recurrence and long-term survival rates were noted. LDLT patients suffered a higher incidence of biliary complications in the early postoperative days. However, during the long-term follow-up period, biliary complication rates were similar between the two groups. The long-term survival rate of patients undergoing emergency transplantation was lower than of patients undergoing elective transplantation. However, no significant difference was observed between emergency LDLT and emergency DDLT.
  
  
  CONCLUSIONS
  Patients undergoing LDLT achieved similar outcomes to patients undergoing DDLT. Although LDLT patients may suffer a higher incidence of early biliary complications, the total biliary complication rate was similar during the long-term follow-up period.
authors.affiliation: Division of Liver Transplantation, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Chuan
authors.initials: C
authors.lastname: Li
authors.forename: Kai
authors.initials: K
authors.lastname: Mi
authors.forename: Tian fu
authors.initials: Tf
authors.lastname: Wen
authors.forename: Lu nan
authors.initials: Ln
authors.lastname: Yan
authors.forename: Bo
authors.initials: B
authors.lastname: Li
authors.forename: Jia ying
authors.initials: Jy
authors.lastname: Yang
authors.forename: Ming qing
authors.initials: Mq
authors.lastname: Xu
authors.forename: Wen tao
authors.initials: Wt
authors.lastname: Wang
authors.forename: Yong gang
authors.initials: Yg
authors.lastname: Wei
mesh_terms: D000328:Adult; D001660:Biliary Tract Diseases / Q000209:etiology; D016063:Blood Loss, Surgical; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B; D006801:Humans; D008107:Liver Diseases / Q000150:complications / Q000628:therapy*; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
references.citation: Am J Transplant. 2009 Apr;9(4):773-81
references.pmid: 19344466
references.citation: Hepatology. 2010 Mar;51(3):903-11
references.pmid: 20041403
references.citation: Liver Transpl. 2011 Jan;17(1):47-52
references.pmid: 21254344
references.citation: Am J Transplant. 2008 Dec;8(12):2569-79
references.pmid: 18976306
references.citation: Transplant Proc. 2005 Nov;37(9):3878-80
references.pmid: 16386570
references.citation: Hepatol Res. 2007 Apr;37(4):305-9
references.pmid: 17397519
references.citation: Anesth Analg. 2005 Jul;101(1):30-7, table of contents
references.pmid: 15976201
references.citation: Liver Transpl. 2009 Dec;15(12):1688-95
references.pmid: 19938120
references.citation: Transpl Int. 2007 Aug;20(8):675-81
references.pmid: 17521384
references.citation: Ann Surg. 2009 Aug;250(2):187-96
references.pmid: 19638912
references.citation: Transplant Proc. 2010 Dec;42(10):4154-7
references.pmid: 21168650
references.citation: Transplantation. 2006 May 27;81(10):1373-85
references.pmid: 16732172
references.citation: Transplant Proc. 2003 Sep;35(6):2318-9
references.pmid: 14529927
references.citation: Anesth Analg. 2004 May;98(5):1245-51, table of contents
references.pmid: 15105195
references.citation: Liver Transpl. 2010 May;16(5):668-77
references.pmid: 20440776
references.citation: Liver Transpl. 2009 Nov;15 Suppl 2:S12-8
references.pmid: 19877292
references.citation: Hepatology. 2011 May;53(5):1570-9
references.pmid: 21520172
references.citation: Pediatr Transplant. 2002 Aug;6(4):301-7
references.pmid: 12234270
references.citation: J Gastrointest Surg. 2011 Jun;15(6):982-7
references.pmid: 21380632
references.citation: J Surg Res. 2008 May 15;146(2):172-6
references.pmid: 18155251
references.citation: Transplant Proc. 2010 Mar;42(2):517-20
references.pmid: 20304182
references.citation: J Hepatol. 2007 Nov;47(5):728-9
references.pmid: 17868949
references.citation: Surg Today. 2008;38(9):795-800
references.pmid: 18751944
references.citation: J Hepatol. 1995 Jun;22(6):623-32
references.pmid: 7560856
references.citation: Liver Int. 2011 Nov;31(10):1477-84
references.pmid: 21745275
references.citation: Intern Med J. 2010 Sep;40(9):619-25
references.pmid: 20840212
references.citation: Zhonghua Yi Xue Za Zhi. 2005 Dec 28;85(49):3460-3
references.pmid: 16686060
references.citation: Am J Transplant. 2005 Jan;5(1):149-56
references.pmid: 15636624
references.citation: Liver Transpl. 2008 Jan;14(1):73-80
references.pmid: 18161843
references.citation: J Hepatol. 2009 Feb;50(2):306-13
references.pmid: 19070386
references.citation: Transplant Proc. 2010 Apr;42(3):865-70
references.pmid: 20430192
references.citation: Singapore Med J. 2006 Jul;47(7):599-603
references.pmid: 16810432
references.citation: Liver Transpl. 2004 Nov;10(11):1379-85
references.pmid: 15497160
references.citation: Radiographics. 2006 Jul-Aug;26(4):1187-209
references.pmid: 16844941
references.citation: Chin Med J (Engl). 2002 Nov;115(11):1679-82
references.pmid: 12609087
references.citation: Transplant Proc. 2007 Nov;39(9):2781-4
references.pmid: 18021986
references.citation: Surg Today. 2009;39(5):367-73
references.pmid: 19408072
references.citation: Am J Transplant. 2010 Mar;10(3):612-8
references.pmid: 20121746
references.citation: Transplantation. 2005 Oct 27;80(8):1072-80
references.pmid: 16278588
references.citation: Arch Surg. 1997 Oct;132(10):1098-103
references.pmid: 9336508
references.citation: J Gastrointest Surg. 2009 Aug;13(8):1480-6
references.pmid: 19430850
references.citation: Cleve Clin J Med. 2009 May;76 Suppl 3:S10-3
references.pmid: 19465703
references.citation: Ann Surg. 2004 Aug;240(2):205-13
references.pmid: 15273542
references.citation: J Hepatol. 2008;48 Suppl 1:S20-37
references.pmid: 18304676
references.citation: N Engl J Med. 1990 May 24;322(21):1505-7
references.pmid: 2336076
references.citation: J Am Coll Surg. 2009 May;208(5):896-903; discussion 903-5
references.pmid: 19476857
references.citation: Zhonghua Yi Xue Za Zhi. 2005 Mar 16;85(10):657-60
references.pmid: 15932725
references.citation: J Hepatol. 2009 Oct;51(4):715-24
references.pmid: 19576652
references.citation: Arch Surg. 2005 May;140(5):465-70; discussion 470-1
references.pmid: 15897442
references.citation: Transpl Int. 2010 Jan;23(1):14-22
references.pmid: 19691661
references.citation: Ann Surg. 2011 Apr;253(4):817-25
references.pmid: 21475025
references.citation: Liver Transpl. 2004 Oct;10(10):1263-8
references.pmid: 15376301
references.citation: Liver Transpl. 2001 Oct;7(10):890-5
references.pmid: 11679988
references.citation: World J Gastroenterol. 2010 Jun 7;16(21):2682-8
references.pmid: 20518092