A study published in Liver Transplantation, a journal of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, reports that donor mortality is about 1 in 500 donors with living donor liver transplantation (LDLT). Research of transplant centers around the world found that those with more experience conducting live donor procedures had lower rates of aborted surgery and life-threatening "near-miss" events.
For patients with end-stage liver disease, liver transplantation is their only option to prolong life. However, more than 16,000 Americans are currently on the waiting list for a liver according to the Organ Procurement and Transplantation Network (OPTN). The critical shortage of deceased donor organs has increased LDLT-a procedure that uses a healthy portion of the liver from a living donor for transplant. Although prior research shows that LDLT is an effective treatment, a 2007 study by de Villa et al. found that LDLT accounts for less than five percent of liver transplants in the U.S. and Europe.
"Donors who decide to provide a portion of their liver to a loved one in need are making an extremely difficult decision to save the life of another," explains lead author Dr. Elizabeth Pomfret, Professor of Surgery at Tufts University and Chair of the Department of Transplantation and Hepatobiliary Diseases at Lahey Hospital & Medical Center in Burlington, Mass. "It is our responsibility as transplant specialists to provide donors with comprehensive information and education relating to LDLT, including any risks, so they may make informed decisions about donation."
To extend understanding of potential risks for liver lobe donors, the team conducted a web-based survey of 148 transplant centers around the world that perform LDLTs. Center representatives were asked to provide donor demographics; morbidity and mortality incidence; "near-miss" event data, and number of aborted procedures. Potentially life-threatening "near-miss" events included severe intraoperative bleeding, reoperation for bleeding, biliary reconstruction and pulmonary embolism.