Liver Transplants: Living Vs. Deceased Donors

Survival rates and other outcome measures for liver transplant from a living donor compare favorably with transplants from deceased donors.

According to findings presented at the 2014 Liver Meeting of the American Association for the Study of Liver Diseases (AASLD), live-donor livers are also valuable because they help to ameliorate the shortage of available transplant organs.

To compare outcomes of transplants from living and deceased liver donors, researchers analyzed national transplant data from the Organ Procurement and Transplant Network/United Network for Organ Sharing between 1999 and 2012.

They found that the three-year “unadjusted graft survival from living-donor liver transplants” increased from 63.4% in 1999 to 82.2% in 2008.

David Goldberg, MD, medical director for living-donor liver transplantation, Hospital of the University of Pennsylvania, Philadelphia, PA, commented, “As a community, we should consider increased use of living-donor liver transplantation to help bridge the organ-supply demand gap, as long as it can be done without compromising donor safety. Recent AASLD guidelines for transplantation suggest that living-donor transplantation is controversial. These data suggest that the issue, at least from the recipient side, is less controversial.”

Although the study did underscore the favorable outcomes of live-donor transplants, Julie Heimbach, MD, surgical director, Liver Transplantation, Mayo Clinic, Rochester, MN, remarked, “We would all much prefer not to operate on healthy people who are undergoing a major procedure for the benefit of someone else, thus having two people at risk for complications related to the surgery instead of one.”

At the end of the day, according to Heimbach, the decision to use a live or deceased donor should reflect the specific patient’s disease, organ availability, and level of center’s expertise.