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World J Gastroenterol. Dec 14, 2012; 18(46): 6729-6736
Published online Dec 14, 2012. doi: 10.3748/wjg.v18.i46.6729
Adult to adult living related liver transplantation: Where do we currently stand?
Erica M Carlisle, Giuliano Testa
Erica M Carlisle, Giuliano Testa, Department of Surgery, Baylor University Medical Center, Dallas, TX 75246, United States
Author contributions: Carlisle EM and Testa G both participated in the research, planning, and editing of the of the manuscript; Carlisle EM was the primary writer of the manuscript.
Correspondence to: Giuliano Testa, MD, Professor of Surgery, Department of Surgery, Baylor University Medical Center, 3410 Worth Street, Dallas, TX 75246, United States. giuliano.testa@baylorhealth.edu
Telephone: +1-214-8202050 Fax: +1-214-8204527
Received: April 18, 2012
Revised: August 3, 2012
Accepted: August 14, 2012
Published online: December 14, 2012
Abstract

Adult to adult living donor liver transplantation (AALDLT) was first preformed in the United States in 1997. The procedure was rapidly integrated into clinical practice, but in 2002, possibly due to the first widely publicized donor death, the number of living liver donors plummeted. The number of donors has since reached a steady plateau far below its initial peak. In this review we evaluate the current climate of AALDLT. Specifically, we focus on several issues key to the success of AALDLT: determining the optimal indications for AALDLT, balancing graft size and donor safety, assuring adequate outflow, minimizing biliary complications, and maintaining ethical practices. We conclude by offering suggestions for the future of AALDLT in United States transplantation centers.

Keywords: Adult to adult living donor liver transplantation; Outflow; Graft size; Liver failure; Ethics; Biliary complications