Living Donor Transplantation Feasible for Acute Liver Failure

Study suggests it's a safe treatment option for patients and doesn't increase donor complications

FRIDAY, Sept. 12 (HealthDay News) -- In selected patients with acute liver failure, living donor liver transplantation may be a safe treatment option, according to the results of a small study published in the September issue of Liver Transplantation.

Jeffrey Campsen, M.D., of the Division of Transplant Surgery at the University of Colorado in Aurora, and colleagues studied outcomes in 13 selected patients who received a right hepatic lobe graft, 10 of them from living donors and three from deceased donors.

After a median follow-up of five years, the investigators found that survival rates were 70 percent for the living-donor recipients and 67 percent for the deceased-donor recipients. Of the four deaths (three among living-donor recipients and one among deceased-donor recipients), two resulted from graft failure and two resulted from fungal infections. All of the living donors survived. The researchers observed 39 complications in 11 recipients and seven complications in five of the donors, and concluded that the risk for donors was comparable to living donor liver transplantation for other indications.

"Concerns about both the added donor risk and inferior recipient outcome, which have led to the proscription of acute liver failure as an indication for living donor liver transplantation in the New York Department of Health's guidelines, were not borne out in this Adult-to-Adult Living Donor Liver Transplantation Cohort Study," states the author of an accompanying editorial. "Nonetheless, the number of patients was small, and the power of the study was probably too low to generate enough assurance to change these guidelines. Living donor liver transplantation, as a strategy that potentially allows optimal timing of liver transplantation for acute liver failure, will continue to have a limited role in the United States."

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