Pauline Brige1, Géraldine Hery2, Sophie Chopinet3, Anaïs Palen4, Daniel Azoulay5, Emilie Gregoire6. 1. Aix-Marseille University, Experimental Interventional Imaging Laboratory, European Center for Medical Imaging Research, Marseille, France. 2. Aix-Marseille University, Experimental Interventional Imaging Laboratory, European Center for Medical Imaging Research; Aix-Marseille University, Department of Pediatric Surgery and Liver Transplantation, Hôpital de la Timone Enfant, Marseille, France. 3. Aix-Marseille University, Experimental Interventional Imaging Laboratory, European Center for Medical Imaging Research; Aix-Marseille University, Department of General Surgery and Liver Transplantation, Hôpital de la Timone, Marseille, France. 4. Aix-Marseille University, Experimental Interventional Imaging Laboratory, European Center for Medical Imaging Research. 5. Department of HPB Surgery and Liver Transplantation, Hôpital Henri-Mondor, Créteil; University Paris Est Créteil, Mondor Institute of Biomedical Research, INSERM U955, France. 6. Aix-Marseille University, Experimental Interventional Imaging Laboratory, European Center for Medical Imaging Research; Aix-Marseille University, Department of General Surgery and Liver Transplantation, Hôpital de la Timone, Marseille, France. emilie.gregoire@ap-hm.f.
Abstract
BACKGROUND AND AIMS: The main restriction in the development of adult-adult Living Donor Liver Transplantation (LDLT) is the risk of morbidity and mortality for donors, which raises ethical questions. The objectives of this study are to review published studies dealing with morbidity and mortality in LDLT and to identify the proposed management and strategies for preventing donor mortality and morbidity in LDLT. METHODS: The Medline database was searched from 2000 to 2017 using the MeSH terms "liver transplantation" and "morbidity" or "mortality" in combination with keywords "living donor liver transplantation". RESULTS: Among the 382 articles obtained, 43 articles were relevant for morbidity, 15 for mortality and 6 for both morbidity and mortality. Twenty-three papers reported donor deaths. The major cause of death was sepsis (30%). Morbidity ranged from 10% to 78.3% depending on the studies. CONCLUSIONS: The living donors' morbidity and mortality is high, currently representing the main restriction in the development of LDLT. Some promising techniques, such as the donor portal vein flow modulation could lead to the further development of LDLT.
BACKGROUND AND AIMS: The main restriction in the development of adult-adult Living Donor Liver Transplantation (LDLT) is the risk of morbidity and mortality for donors, which raises ethical questions. The objectives of this study are to review published studies dealing with morbidity and mortality in LDLT and to identify the proposed management and strategies for preventing donor mortality and morbidity in LDLT. METHODS: The Medline database was searched from 2000 to 2017 using the MeSH terms "liver transplantation" and "morbidity" or "mortality" in combination with keywords "living donor liver transplantation". RESULTS: Among the 382 articles obtained, 43 articles were relevant for morbidity, 15 for mortality and 6 for both morbidity and mortality. Twenty-three papers reported donor deaths. The major cause of death was sepsis (30%). Morbidity ranged from 10% to 78.3% depending on the studies. CONCLUSIONS: The living donors' morbidity and mortality is high, currently representing the main restriction in the development of LDLT. Some promising techniques, such as the donor portal vein flow modulation could lead to the further development of LDLT.