Current Status of Living Donor Liver Transplantation: Impact, Advantages, and Challenges.

Q1 Medicine Current Gastroenterology Reports Pub Date : 2023-10-01 Epub Date: 2023-08-21 DOI:10.1007/s11894-023-00882-9
Hao Liu, Eishan Ashwat, Abhinav Humar
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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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活体肝移植的现状:影响、优势和挑战。
本综述的目的:本综述综述了活体供肝移植(LDLT)的现状。它讨论了LDLT对等待名单和移植后结果的影响,强调了LDLT的技术挑战和独特优势。最近的研究结果:最近的研究结果表明,LDLT在理论上比已故供体肝移植有几个优势,包括更短的等待时间、更好的移植物质量和更好的移植后预后。在美国,非酒精性脂肪性肝病(NAFLD)和肝细胞癌(HCC)正在成为成人LDLT的主要适应症。与死亡供体移植相比,LDLT显示出相当或更好的总生存率和器官特异性结果。然而,挑战仍然存在,包括供体和受体风险,如胆道并发症和小体型综合征。正在进行的研究侧重于改进手术技术,探索微创方法,利用预定的供体来调节受体的免疫系统,并确保道德实践。对于需要移植的终末期肝衰竭或疾病患者,LDLT是一种有价值的解决方案。它提供了诸如更短的等待时间以及改进的等待名单和移植后的结果等优势。LDLT的持续研究和进步将使需要肝移植的患者受益。
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来源期刊
Current Gastroenterology Reports
Current Gastroenterology Reports Medicine-Gastroenterology
CiteScore
7.80
自引率
0.00%
发文量
19
期刊介绍: As the field of gastroenterology and hepatology rapidly evolves, the wealth of published literature can be overwhelming. The aim of the journal is to help readers stay abreast of such advances by offering authoritative, systematic reviews by leading experts. We accomplish this aim by appointing Section Editors who invite international experts to contribute review articles that highlight recent developments and important papers published in the past year. Major topics in gastroenterology are covered, including pediatric gastroenterology, neuromuscular disorders, infections, nutrition, and inflammatory bowel disease. These reviews provide clear, insightful summaries of expert perspectives relevant to clinical practice. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. We also provide commentaries from well-known figures in the field.
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