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Liu H, Ashwat E, Humar A. Current Status of Living Donor Liver Transplantation: Impact, Advantages, and Challenges. Curr Gastroenterol Rep 2023; 25:225-231. [PMID: 37603108 DOI: 10.1007/s11894-023-00882-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2023] [Indexed: 08/22/2023]
Abstract
PURPOSE OF THIS REVIEW This review provides an overview of the current status of Living Donor Liver Transplant (LDLT). It discusses the impact of LDLT on waitlist and post-transplantation outcomes, highlighting the technical challenges and unique advantages of LDLT. RECENT FINDINGS Recent findings show that LDLT offers several theoretical advantages over deceased donor liver transplant, including shorter wait times, better graft quality, and improved post-transplant outcomes. Non-alcoholic fatty liver disease (NAFLD) and hepatocellular carcinoma (HCC) are emerging as the leading indications for adult LDLT in the US. LDLT demonstrates comparable or better overall survival rates and organ-specific outcomes compared to deceased donor transplants. However, challenges exist, including donor and recipient risks such as biliary complications and small-for-size syndrome. Ongoing research focuses on refining surgical techniques, exploring minimally invasive approaches, utilizing predetermined donors to modulate the recipient's immune system, and ensuring ethical practices. LDLT is a valuable solution for patients with end-stage liver failure or disorders requiring transplantation. It offers advantages such as shorter wait times as well as improved waitlist and post-transplant outcomes. Continued research and advancements in LDLT will benefit patients in need of liver transplantation.
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Affiliation(s)
- Hao Liu
- Division of Transplantation, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213, USA
| | - Eishan Ashwat
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Abhinav Humar
- Division of Transplantation, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213, USA.
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Sayed BA, Cattral M, Ghanekar A, Ng VL. Insufficient use of technical variant grafts: An unfulfilled promise in pediatric liver transplantation. Liver Transpl 2023; 29:663-664. [PMID: 37067384 DOI: 10.1097/lvt.0000000000000158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 04/05/2023] [Indexed: 04/18/2023]
Affiliation(s)
- Blayne A Sayed
- Division of General Surgery, Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
- Division of General & Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
- Transplant and Regenerative Medicine Center, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mark Cattral
- Division of General Surgery, Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
- Division of General & Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
- Transplant and Regenerative Medicine Center, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Anand Ghanekar
- Division of General Surgery, Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
- Division of General & Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
- Transplant and Regenerative Medicine Center, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Vicky L Ng
- Transplant and Regenerative Medicine Center, The Hospital for Sick Children, Toronto, Ontario, Canada
- Division of Gastroenterology, Hepatology, and Nutrition, The Hospital for Sick Children, Toronto, Ontario, Canada
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Feldman AG, Adams M, Griesemer AD, Horslen S, Kelly B, Mavis AM, Mazariegos GV, Ng VL, Perito ER, Rodriguez-Davalos MI, Squires JE, Tiao G, Yanni GS, Hsu EK. Advancing the Field of Pediatric Liver Transplantation: Urgent Action Items Identified During the 2022 Society of Pediatric Liver Transplantation Meeting. Transplantation 2023; 107:1223-1225. [PMID: 37220339 DOI: 10.1097/tp.0000000000004584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
- Amy G Feldman
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, The University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO
| | - Megan Adams
- Department of Surgery, Colorado Center for Transplantation Care, Research and Education, The University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO
| | | | - Simon Horslen
- Division of Gastroenterology, Hepatology and Nutrition, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA
| | | | - Alisha M Mavis
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Duke University, Durham, NC
| | - George V Mazariegos
- Department of Surgery, Hillman Center for Pediatric Transplantation, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Vicky L Ng
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Emily R Perito
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA
| | - Manuel I Rodriguez-Davalos
- Transplant and Hepatobiliary Surgery, Primary Children's Hospital- Intermountain Healthcare; University of Utah, Salt Lake City, Utah
| | - James E Squires
- Division of Gastroenterology, Hepatology and Nutrition, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA
| | - Greg Tiao
- Department of Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - George S Yanni
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital of Los Angeles, The Keck USC School of Medicine, Los Angeles, CA
| | - Evelyn K Hsu
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition University of Washington School of Medicine, Seattle Children's Hospital, Seattle, WA
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Yoeli D, Adams MA, Pomfret EA. The current landscape of pediatric living donor liver transplantation in the United States: Benefits, challenges, and future directions. Clin Liver Dis (Hoboken) 2023; 21:107-110. [PMID: 37197222 PMCID: PMC10184998 DOI: 10.1097/cld.0000000000000036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/14/2023] [Indexed: 05/19/2023] Open
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