Live donor liver transplantation (LDLT) can be done in cases of acute liver failure where the complications arise rapidly and deteriorates the patients health, finds a new research.
Acute liver failure results in coma and death in more than 80% of cases if it is left untreated. The only effective therapy is liver transplantation, but the deceased donor supply of livers is often not timely enough.
LDLT is an attractive option to overcome this problem, but studies haven't looked at the safety of the procedure for acute liver failure patients or donors who may have to have last-minute examinations to determine their compatibility.
Experts worry that individuals perhaps should not be allowed to make donor-related decisions when faced with the death of a loved one, although denying someone the opportunity to save a loved one's life is sub-optimal as well.
Dr.Markus Selzner, Multi-Organ Transplant Program at Toronto General Hospital, and his colleagues, reported on their hospital's experience using LDLT for treating adult patients suffering from acute liver failure.
From 2006 to 2013, all seven patients with acute liver failure who underwent a LDLT were compared with all 26 patients who underwent a deceased donor liver transplantation (DDLT). For LDLT, liver transplantation was performed within 18 to 72 hours after living donor evaluation was initiated.
LDLT versus DDLT had similar incidences of overall postoperative complications and no differences were detected between LDLT and DDLT patients and no severe donor complications occurred after LDLT.
"Since acute liver failure can deteriorate within hours or days to coma or death, waiting time is critical for this patient group. If a living donor is available, liver transplantation can be performed without delay, reducing the risk of death or permanent disability of the recipient," said Dr. Selzner.
In an accompanying editorial, Dr.Jean Emond, Columbia University, NYC, and Dr.Charles Rosen, of the Mayo Clinic in Rochester, Minnesota, congratulate the researchers for their pioneering work. They noted, "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."