Live liver donation: a prospective analysis of exclusion criteria for healthy and potential donors

• Published in: Transplantation proceedings 2003-08, Vol.35 (5), p.1787-1790
• Main Authors: Moreno Gonzalez, E, Meneu Diaz, J.C, Garcia Garcia, I, Loinaz Segurola, C, Jimenez, C, Gomez, R, Abradelo, M, Elola, A.Moreno, Jimenez, S, Ferrero, E, Calvo, J, Manrique, A, Herrero, M.L
• Format: Article
• Language: English
• Subjects: ABO Blood-Group System; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Group Incompatibility; Cadaver; Clinical death. Palliative care. Organ gift and preservation; Humans; Liver; Liver Transplantation - physiology; Liver, biliary tract, pancreas, portal circulation, spleen; Living Donors - statistics & numerical data; Medical sciences; Patient Selection; Prospective Studies; Reoperation - statistics & numerical data; Retrospective Studies; Risk Factors; Safety; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/S0041-1345(03)00666-3

Living donor liver transplantation represents a controversial option to increase the donor pool. Prospective and descriptive clinical study. (1) To identify risk factors (exclusion criteria) for live donation; (2) to determine the rate of recipients that benefit from a living donor. Between May 1995 (first adult-to-adult living donor liver transplantation in Spain) and November 2002, we evaluated 74 healthy volunteers and performed 12 living donor liver transplants (no donor mortality). All actual donors and volunteers are alive and healthy. After a mean time of 3.2 ± 0.5 weeks, 72% of potential donors were considered unsuitable for live donation. Exclusion criteria were grouped in three categories: (1°) donor safety reasons (68%); (2°): ABO mismatch (17%) and (3°): cadaveric graft transplantation (15%). Consequently, just 43.7% of the recipients presenting to us with a potential living donor, did finally benefit from these organs. The mortality rate was 8.3% for 43 recipients presenting with a living donor in comparison to 15% for those who did not (321 recipients between May 1995 and November 2001). ALDLT can benefit a significant number of recipients on the waiting list (43.7% of those presenting with a donor). The most frequent exclusion criteria concern donor safety, namely, unsuspected chronic liver diseases and unsuspected thrombophilic disorders.