REVIEW ARTICLE
Year : 2017  |  Volume : 8  |  Issue : 1  |  Page : 4-10

Adult-to-adult living donor liver transplantation: Operative techniques to optimize the recipient's outcome


1 Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
2 Department of Surgery, The University of Hong Kong, Hong Kong, SAR, China

Correspondence Address:
See Ching Chan
Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam Road, Hong Kong, SAR
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0976-9668.198356

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Adult-to-adult living donor liver transplantation (LDLT) is widely accepted today with good outcomes and safety reported worldwide for both donor and recipient. Nonetheless, it remained a highly demanding technical and complex surgery if undertaken. The last two decades have seen an increased in adult-to-adult LDLT following our first report of right lobe LDLT in overcoming graft size limitation in adults. In this article, we discussed the operative techniques and challenges of adult right lobe LDLT incorporating the middle hepatic vein, which is practiced in our center for the recipient operation. The various issues and challenges faced by the transplant surgeon in ensuring good recipient outcome are explored and discussed here as well. Hence, it is important to understand that a successful recipient operation is dependent of multifactorial events starting at the preoperative stage of planning, understanding the intraoperative technical challenges and the physiology of flow modulation that goes hand-in-hand with the operation. Therefore, one needs to arm oneself with all the possible knowledge in overcoming these technical challenges and the ability to be flexible and adaptable during LDLT by tailoring the needs of each patient individually.


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