Chapter 23

Living Donor Liver Transplant in Children

Adebowale A. Adeyemi

Adebowale A. Adeyemi

Liver Transplant Program, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA

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Elizabeth B. Rand

Elizabeth B. Rand

Liver Transplant Program, The Children's Hospital of Philadelphia, Philadelphia, PA, USA

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Kim M. Olthoff

Kim M. Olthoff

Liver Transplant Program, The Children's Hospital of Philadelphia, Philadelphia, PA, USA

Division of Transplant Surgery, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

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First published: 12 March 2021

Summary

The disparity between the number of appropriately sized deceased donor liver grafts and number of children awaiting liver transplant continues to be significant and has led to increasing use of technical variant grafts, including living donor liver grafts. With increasing use of these grafts, technical advancements have been made, leading to safer donor procedures and increasing graft and recipient survival. There remains an overall expertise gap when comparing the use of living donors for pediatric transplants in the US versus other countries where living donor liver transplantation (LDLT) is the norm. Increasing use of technical variant grafts and living donor grafts will not only close this gap, but further decrease wait-list mortality in the very young children who are currently disadvantaged. The major disadvantage of LDLT is the fact that a healthy individual is subjected to a major surgery with potential medical or surgical complications, including death.

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