Adult Living Donor Liver Transplantation: Current Status
Living donor liver transplantation was developed in response to a shortage of full-size grafts for children. The progression from reduced-size cadaveric grafts to use of living donors occurred subsequent to expansion of liver anatomy knowledge and practical use of hepatic segments. A major benefit of pediatric live donor liver transplantation is the grafting of children without using livers from the cadaver donor pool. A major drawback of the procedure relates to the need to perform surgery and assign risk to an otherwise healthy individual. The ethical challenge has been discussed in detail and, although not ideal, the procedure “passes muster” on grounds of informed consent and the good of helping another human being. Formidable success appears to have been attained with the adult-to-adult procedure thus far; however, the transplant community still awaits center-specific and compiled data to determine whether the procedure truly reduces adult waiting list times for liver transplant recipients with minimal donor risk.