Technical advances in living-related liver transplantation.

Since it was first reported in 1989, living-related liver transplantation (LRLT) has developed, and up to April, 1998, over 800 LRLTs had been performed worldwide. The past few years have seen considerable technical advances in LRLT, including selective vascular occlusion techniques for donor hepatectomy, arterial reconstruction using microscopy, and the introduction of intraoperative ultrasound and graft volume estimation, using the concept of standard liver volume, which have enabled LRLT to be extended to adult recipients. Successful results have led to LRLT becoming an indispensable modality to overcome the shortage of cadaveric liver grafts in Western countries. In places where transplantation of organs from brain-dead donors is rarely practiced, such as in most Asian countries, LRLT is the only means of saving patients with end-stage liver disease who otherwise would have no chance of survival. LRLT is now globally accepted as an effective liver transplantation modality.