The application of paired donation to live donor liver transplantation

✍ Scribed by Dorry L. Segev; Robert A. Montgomery

• Publisher: John Wiley and Sons
• Year: 2010
• Tongue: English
• Weight: 62 KB
• Volume: 16
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.22062

✦ Synopsis

The last decade has seen substantial growth and expansion of kidney paired donation (KPD), a modality by which pairs of incompatible live kidney donors and their intended recipients exchange kidneys such that compatible transplants result, both in the United States 1-4 and internationally. [5][6][7] In this issue of Liver Transplantation, 2 independent groups take this concept into the realm of live donor liver transplantation. At Queen Mary Hospital in Hong Kong, motivated by a high-urgency acute liver failure, Chan and colleagues 8 matched 2 ABO-incompatible (ABOi) live donor pairs, and this resulted in 2 compatible and successful transplants. Hwang and colleagues 9 describe 16 patients who underwent live donor liver transplantation in the first 6 years of their exchange program at the Asan Medical Center in Seoul.

In the United States, deceased donor allocation in the Model for End-Stage Liver Disease era has been very successful in allocating livers to the sickest patients. In the example illustrated by Chan and colleagues, 8 a patient in the United States with high-urgency acute liver failure would have a high likelihood of expeditiously receiving a deceased donor allograft. The balance between donor risk and reduced recipient waiting list mortality may account for the relatively low rate of live donor liver transplantation in the United States. As a result, incompatible donor/recipient pools in the United States are likely to remain small, and the impact of liver paired donation (LPD) in the United States is likely to be limited. This is contrasted with countries such as China, Korea, and Japan in which cultural or religious beliefs have