Adult-to-adult living-donor liver transplantation: A critical analysis

Adult-to-adult living-donor liver transplantation is the most recent achievement in the evolution of strategies to increase donor organ supply. Justification of the procedure has evolved from increased organ-waiting times, wait-list morbidity and mortality of adult transplant candidates. Successful application of adult-to-adult hiving-donor liver transplantation mandates unique surgical, medical, and donor considerations as these procedures predispose to unique complications resulting from anatomic variations, technical considerations and the transplantation of "partial" grafts. Additionally, because the magnitude of the dorter operation is greater and potentially fraught with serious short and long term morbidity and possibly mortality, the utilization of living-donors for adult fiver transplantation raises bio-ethical concerns heretofore not encounter-ed. This review explores the current state of adult-to-adult living-donor liver transplantation.