Clinical

Living donor liver transplants offer fewer complications than cadaveric organs

Last Updated: 2003-10-13 17:13:29 -0400 (Reuters Health)

By Megan Rauscher

NEW YORK (Reuters Health) - Living donor liver transplantation (LDLT) is associated with a lower rate of serious complications and rejection and may have a slightly higher survival than orthotopic liver transplantation, according to intermediate term morbidity and mortality data from 92 patients who underwent LDLT at the University of Rochester in New York between 2001 and 2002.

The study represents the largest single-center study of LDLT in the U.S., Dr. Parvez S. Mantry told Reuters Health. He presented the results Monday during the 68th Scientific Meeting of the American College of Gastroenterology in Baltimore, Maryland.

"From the donor standpoint, we published data separately showing that it is an extremely safe procedure," Dr. Mantry told Reuters Health.

In the current study, most recipients tolerated the procedure "very well," he said, with 86% not experiencing any significant complications, and the survival rate was "pretty good," with 92% of patients alive at 6 months.

"Although I published just the intermediate term mortality, we are seeing that patients who underwent LDLT even two or three years ago are for the most part doing quite well," Dr. Mantry told Reuters Health.

The biliary and vascular complication rate for the Rochester LDLT cohort (6.7% and 2.2%, respectively) is lower than that reported nationally (22% and 9.8%, respectively), the research team notes in a meeting abstract.

"The only condition where we have to be a little watchful, and again that is evolving, is chronic hepatitis C," Dr. Mantry said. "These patients may have a higher morbidity from LDLT although those data are not yet completely assimilated."

"LDLT, from my perspective, is a very good alternative to cadaveric liver transplantation mainly because the shortage of organs is so great," Dr. Mantry said.

New York State has the largest waiting list in the country but the least number of organs supplied from cadavers so there is a "huge gap between supply and demand," he explained, "which is why we like to bank on living donor liver transplantation."

Dr. Mantry said he believes that LDLT is "certainly going to catch on and will definitely be a large part of liver transplantation in the future."