Liver Transpl 2000 Jan;6(1):3-20

Right lobe living donor liver transplantation: a review.

Marcos A

Department of Surgery, Division of Transplantation, Medical College of Virginia,
Virginia Commonwealth University, Richmond, VA 23298-0057, USA.

Abstract
The continuing shortage of organs for adult transplant recipients has generated
enthusiasm for adult-to-adult living donor liver transplantation (LDLT). The
major concern has been the ability to resect a graft of adequate size without
subjecting the donor to undue risk. The right hepatic lobe is generally large
enough for adult recipients, but because of the real and perceived risks of
right lobe (RL) resection, surgeons have been hesitant to offer this option to
their patients. The first series of RL resections that included a significant
number of patients was reported in 1999, and the results were encouraging. Only
minor complications occurred in donors, and the recipients fared quite well.
Enthusiasm for these donor resections is growing, and more centers are beginning
to perform them. There is a good deal of global experience with pediatric LDLT
but little with adults, and there are unique considerations in this population.
This review examines donor selection criteria for adult recipients, highlights
technical points critical for good outcome, and examines the early results and
complications in both donors and recipients. If the preliminary results continue
to be reproduced, RL LDLT could have significant impact on the worsening organ
shortage.