Living donor liver transplantation in adults: recent advances and results.

BACKGROUND Living donor liver transplantation (LDLT) is now widely performed for adult patients to resolve the critical shortage of organs from cadavers. The objective of this study was to analyze the experience of a single center with adult LDLT. METHODS Eighty-two consecutive LDLT procedures for adults were divided into 3 groups according to the transplant era and the preoperative condition and indications: all patients between 1996 and 1999 (Group 1, n = 30), good-risk patients between 2000 and November 2001 (Group 2, n = 28), and poor-risk patients (Group 3, n = 24). Up to 1999, left liver graft was used for all patients. Thereafter, right liver was selected only for poor-risk patients. Preoperative status, morbidity, hospital duration, and postoperative graft function and survival rate were examined and compared among the groups. RESULTS Comparison of groups 1 and 2 revealed a significant difference in the hospital duration and the survival rate. In contrast, the short-term surgical results were comparable between groups 2 and 3. The 2-year survival rates were 84%, 100%, and 88%, respectively. CONCLUSIONS The present results suggest that our graft selection criteria are acceptable. A small graft can provide satisfactory results when used in good-risk patients and a right liver graft may be beneficial in poor-risk patients.