Living-donor liver transplantation

2 Indications and current treatments

2.1 Liver transplantation is a treatment option for patients with end‑stage liver failure. It may also be indicated in patients with some types of primary liver cancer. End‑stage liver failure can be either acute (for example, from poisoning) or chronic (for example, because of advanced cirrhosis due to autoimmune, infectious, metabolic or alcoholic liver disease). In children, the most common cause of end‑stage liver failure is congenital biliary atresia.

2.2 Deceased-donor liver transplantation is the established procedure for patients needing liver transplantation. Limited availability of deceased donor livers led to the development of techniques which increase the number of recipients who can benefit from 1 available organ. These include split liver grafts (the larger right lobe is usually grafted into an adult and the left lobe into a child) and reduced (segmental) liver grafts.

2.3 The limited availability of deceased donor livers, even with these techniques, has been the stimulus for living‑donor transplantation. Living donors are usually blood relatives, but can also be spouses, partners and, in very rare cases, non‑directed altruistic donors (volunteers).

2.4 Living‑donor liver transplantation may be an option for patients who are deteriorating clinically while waiting for a deceased donor transplant.