title: Live donor liver transplantation: a valid alternative for critically ill patients suffering from acute liver failure.
abstract: We report the outcome of live donor liver transplantation (LDLT) for patients suffering from acute liver failure (ALF). From 2006 to 2013, all patients with ALF who received a LDLT (n = 7) at our institution were compared to all ALF patients receiving a deceased donor liver transplantation (DDLT = 26). Groups were comparable regarding pretransplant ICU stay (DDLT: 1 [0-7] vs. LDLT: 1 days [0-10]; p = 0.38), mechanical ventilation support (DDLT: 69% vs. LDLT: 57%; p = 0.66), inotropic drug requirement (DDLT: 27% vs. LDLT: 43%; p = 0.64) and dialysis (DDLT: 2 vs. LDLT: 0 patients; p = 1). Median evaluation time for live donors was 24 h (18-72 h). LDLT versus DDLT had similar incidence of overall postoperative complications (31% vs. 43%; p = 0.66). No difference was detected between LDLT and DDLT patients regarding 1- (DDLT: 92% vs. LDLT: 86%), 3- (DDLT: 92% vs. LDLT: 86%), and 5- (DDLT: 92% vs. LDLT: 86%) year graft and patient survival (p = 0.63). No severe donor complication (Dindo-Clavien ≥3 b) occurred after live liver donation. ALF is a severe disease with high mortality on liver transplant waiting lists worldwide. Therefore, LDLT is an attractive option since live donor work-up can be expedited and liver transplantation can be performed within 24 h with excellent short- and long-term outcomes.
authors: Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, Toronto, ON, Canada.
authors: N
authors: N
authors: Goldaracena
authors: Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, Toronto, ON, Canada.
authors: V N
authors: VN
authors: Spetzler
authors: Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, Toronto, ON, Canada.
authors: M
authors: M
authors: Marquez
authors: Department of Medicine, Toronto General Hospital, Toronto, ON, Canada.
authors: N
authors: N
authors: Selzner
authors: Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, Toronto, ON, Canada.
authors: M S
authors: MS
authors: Cattral
authors: Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, Toronto, ON, Canada.
authors: P D
authors: PD
authors: Greig
authors: Department of Medicine, Toronto General Hospital, Toronto, ON, Canada.
authors: L
authors: L
authors: Lilly
authors: Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, Toronto, ON, Canada.
authors: I D
authors: ID
authors: McGilvray
authors: Department of Medicine, Toronto General Hospital, Toronto, ON, Canada.
authors: G A
authors: GA
authors: Levy
authors: Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, Toronto, ON, Canada.
authors: A
authors: A
authors: Ghanekar
authors: Department of Medicine, Toronto General Hospital, Toronto, ON, Canada.
authors: E L
authors: EL
authors: Renner
authors: Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, Toronto, ON, Canada.
authors: D R
authors: DR
authors: Grant
authors: Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, Toronto, ON, Canada.
authors: M
authors: M
authors: Selzner
mesh_terms: D000328:Adult; D000368:Aged; D002170:Canada; D016638:Critical Illness; D005260:Female; D006801:Humans; D015994:Incidence; D017114:Liver Failure, Acute / Q000601:surgery*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014019:Tissue Donors; D016896:Treatment Outcome
keywords: clinical research / practice; donors and donation: living; fulminant hepatic failure; liver transplantation / hepatology; liver transplantation: living donor