What is a living donor liver transplantation?

Living donor liver transplants started as a way to cope with a shortage of deceased donor organs. Liver transplant surgeon Robert Brown, MD, MPH, explains more about this approach to treating liver disease.

Transcript

00:00

The liver has two lobes, a left lobe and a right lobe. And if we remove one of those lobes, the other one will regenerate up to full size

00:08

in four to six weeks. [CALM MUSIC]

00:16

Living-donor liver transplantation arose because of shortages of deceased donors

00:23

and thus death on the waiting list. The ability to do living-donor transplantation dates back to the early days of kidney transplant

00:32

but was initially thought impossible for liver transplantation. Started in children, who needed a small liver,

00:41

we recognized that the liver's ability to regenerate would allow us to take up to 60% of the donor's liver

00:49

and use it for the recipient and have it regenerate in both the donor and the recipient.

00:56

This has led to the success of living-donor liver transplantation in both children, where it is standard

01:03

of care, and in adults, where we use it in circumstances where the patient is unlikely to be able to make it

01:10

through the waiting list or to improve the quality of life with an earlier transplant.

01:16

The liver has two lobes, a left lobe and a right lobe. And if we remove one of those lobes, the other one will regenerate up to full size

01:24

in four to six weeks. This allows us to remove part of the liver and have it regenerate in both the donor and the recipient.

01:34

We've used the smaller part of the left lobe we call the left lateral segment for babies since the '80s.

01:41

However, when we tried to do left lobe transplants in adults, it was not enough liver for the recipient who was sick and needed more liver

01:50

than the donor. We started doing right lobe liver transplants in the late '90s, and this proliferated and has

01:58

become a successful therapy. Now, increasingly, we're trying to use the left lobe whenever

02:04

possible to decrease the size of the operation for the donor and, in some cases, do it laparoscopically.

02:12

This improves the recovery time and decreases the risk to the donor. [AUDIO LOGO]