Live Donor Liver Transplants Found to be Safe, Effective

Procedure allows acute liver failure patients to receive a transplant before their condition worsens.

Liver transplants from living donors are safe and effective, which can mitigate the rapid severe complications that arise in patients with acute liver failure, according to a recent study.

Acute liver failure can lead to coma and death in more than 80% of cases if the condition goes untreated, with the only effective treatment being liver transplantation. In a study published in the American Journal of Transplantation, researchers examined the safety of live donor liver transplantation (LDLT) for acute liver failure patients and donors who need last-minute evaluations to determine compatibility.

For the study, researchers from the Multi-Organ Transplant Program at Toronto General Hospital examined the use of LDLT in adult patients with acute liver failure from 2006 to 2013. The study compared 7 patients with acute liver failure who received an LDLT with 26 patients who received a deceased donor liver transplantation (DDLT). In patients who received an LDLT, the transplant was performed 18 to 72 hours after the living donor was evaluated.

The researchers found overall postoperative complications occurred in 31% of LDLT procedures, compared with 43% of DDLT procedures. There were no differences found between LDLT and DDLT patients in the 1-year, 3-year, and 5-year liver and patient survival rates and there were no reported incidents of severe donor complications following LDLT.

"Since acute liver failure can deteriorate within hours or days to coma or death, waiting time is critical for this patient group," Markus Selzner, MD, of the Multi-Organ Transplant Program said in a press release. "If a living donor is available, liver transplantation can be performed without delay, reducing the risk of death or permanent disability of the recipient."

In an accompanying editorial, Jean Emond, MD, and Charles Rosen, MD, wrote, "Further experience is necessary to demonstrate that urgent evaluations can be done safely, accurately, and with avoidance of coercion and undue stress on potential donors and their families."