Background: Despite greater awareness of organ donation among the general public, the supply
of cadaveric organs has fallen short of identified needs. Living-donor liver transplantation
(LDLT) is an effective means of overcoming the shortage of adult organs, as outcomes
are now comparable to those of cadaveric donor liver transplantation.
Methods: From January, 2002 through January, 2006, 40 LDLTs were performed at our center.
With two exceptions, the donor was a first-degree relative of the recipient; all donors were in
excellent health with good hepatic function and morphology. All but two donors contributed
the right lobe. Infections in the donors and recipients were analyzed.
Results: Clinically relevant infections occurred in three donors. In the recipients, the infections
did not differ significantly from those experienced by recipients of cadaveric organs
in terms of risk factors (e.g., poor graft function, re-transplantation, surgical complications
such as bile duct stenosis, or vascular anastomotic stenosis) or type of infection. Cholangitis
was the most frequent infection, leading to septic shock in five of the 14 patients with infections;
intra-abdominal infections related to surgical complications led to septic shock in
three additional patients. The other most commonly observed infections were urinary tract
infections (n = 10) and pneumonia (n = 3).
Conclusions: Living-donor liver transplantation offers hope to patients with end-stage liver
disease in geographic areas where the waiting time mortality is high and available organs
from deceased donors fall short of the population's need.
