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Top left: Regeneration of donor liver and recipient donor liver after transplantation
.
Top right: Number
of living donor liver transplants registered in the US, Canada and UK.
Bottom left: In the United States, Canada, and the United Kingdom, LDLT overall usage is low
compared to DDLT.
Bottom right: In the United States, Canada, and the United Kingdom, survival outcomes
for 1, 5, and 10 years after LDLT surgery.
Transplant patients demand more than they can donate liver, with more than 15 percent of waiting list patients dying
a year later.
Donor liver transplantation refers to the removal of a portion of a healthy person's liver into a person who is not functioning
properly.
Identifying differences in outcomes and other transplant characteristics may help identify areas where improvements in health care are needed and clarify whether it is reasonable
to expand donor liver transplant practices in countries that rely primarily on DDLT.
Gonzalo Sapisochin, MD, MSc in General Surgery, University of Toronto, Canada, explains: "There is growing interest in
strategies to alleviate the increased demand for transplants and unacceptably high mortality rates on the liver transplant waiting list.
This is a retrospective, multicenter study of adults aged 18 years or older who received primary donor liver transplantation between January 2008 and December 2018, as reported by three national liver transplant registries: United Network for Organ Sharing (UNOS; USA), National Health Service Blood and Transplantation (NHSBT; UK) and the Canadian Organ Replacement Registry (CORR; Canada).
A total of 2954 ldlts were conducted in these countries, of which 2328 occurred in the United States, 529 in Canada and 97 in the United Kingdom
.
An analysis of LDLT shows that long-term survival rates are excellent, although LDLT use in Western countries is lower than in Asian countries
.
Dr Sapisochin commented: "This study supports the increased use of LDLT in Western countries as it provides an opportunity to reduce the imbalance between organ supply and demand, thus providing candidates with the possibility of early transplantation and reducing the mortality rate
of transplant candidates.
Low utilization of adult-to-adult LDLT in Western countries despite excellent outcomes: International multicenter analysis of the US, UK, and Canada
