This document replaces previous guidance on living‑donor liver transplantation (interventional procedure guidance 194).
1.1 Current evidence on the efficacy and safety of living‑donor liver transplantation appears adequate to support the use of this procedure for suitable donors and recipients with normal arrangements for clinical governance, consent and audit, provided that the necessary regulatory requirements are followed.
1.2 Clinicians and centres doing this procedure must follow the relevant regulatory and legal requirements of the Human Tissue Authority. This includes carrying out independent assessment interviews and getting statutory approval from the Human Tissue Authority before donation can proceed. During the consent process donors and recipients should have thorough physical and psychological screening and monitoring, and counselling about the morbidity and risks associated with this procedure. They should also be provided with clear written information, including relevant information provided by the Human Tissue Authority. In addition, the use of NICE's information for the public is recommended.
1.3 Living-donor liver transplantation should only be done in accordance with the NHS Blood and Transplant (NHSBT) Organ Donation and Transplantation Liver Advisory Group's Liver Selection Policy and the British Transplantation Society's guidelines for Directed Altruistic Organ Donation, taking into account the legal framework for living donation from the Human Tissue Authority. Non‑directed altruistic donation is a possibility and should be discussed with a transplant centre or team.
1.4 Living-donor liver transplantation should be carried out in specialist centres by a multidisciplinary team.
1.5 Clinicians should enter details about all donors and recipients having living‑donor liver transplantation into the NHSBT UK transplant registry, and review clinical outcomes locally.