We read with interest the article by Campsen et al. 1 describing the outcomes of adult-to-adult living donor liver transplantation (LDLT) for acute liver failure (ALF) in the United States. They described 2 concerns in applying LDLT for ALF: appropriate donor evaluation during the rapid evolution of
Outcomes of living donor liver transplantation for acute liver failure: The adult-to-adult living donor liver transplantation cohort study
β Scribed by Jeffrey Campsen; Andres T. Blei; Jean C. Emond; James E. Everhart; Chris E. Freise; Anna S. Lok; Sammy Saab; Karen A. Wisniewski; James F. Trotter
- Publisher
- John Wiley and Sons
- Year
- 2008
- Tongue
- English
- Weight
- 113 KB
- Volume
- 14
- Category
- Article
- ISSN
- 1527-6465
- DOI
- 10.1002/lt.21500
No coin nor oath required. For personal study only.
β¦ Synopsis
For acute liver failure (ALF), living donor liver transplantation (LDLT) may reduce waiting time and provide better timing compared to deceased donor liver transplantation (DDLT). However, there are concerns that a partial graft would result in reduced survival of critically ill LDLT recipients and that the rapid evolution of ALF would lead to selection of inappropriate donors. We report outcomes for ALF patients (and their donors) evaluated for LDLT between 1998 and April 2007 from the Adult-to-Adult Living Donor Liver Transplantation Cohort. Of the 1201 potential LDLT recipients, 14 had ALF, only 6 of whom had an identified cause. The median time from listing to first donor evaluation was 1.5 days, and the median time from evaluation to transplantation was 1 day. One patient recovered without liver transplant, 3 of 10 LDLT recipients died, and 1 of 3 DDLT recipients died. Five of the 10 living donors had a total of 7 posttransplant complications. In conclusion, LDLT is rarely performed for ALF, but in selected patients it may be associated with acceptable recipient mortality and donor morbidity.
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