Characteristics of Liver Grafts in Living-Donor Adult Liver Transplantation

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Abstract
THE NUMBER of living-donor liver transplantations has been on the rise because of the chronic shortage of cadaveric livers, originally for children.1-4 Recently, adult recipients have been included in living donor liver transplantations, especially in Japan, where the availability of brain-dead donors is limited. Compared with a cadaveric liver graft, the quality of the liver graft from the living donor is better owing to the shorter preservation time and better maintenance of the systemic hemodynamic state. In contrast, the liver graft volume (GV) is smaller owing to a partial liver graft; therefore, a problem of small-for-size grafts often occurs in the living-donor adult liver transplantations (LDALTs).5-7 The GV for a successful transplant is ideally more than 40% of the standard liver volume (SLV).7,8 In adult recipients, if a left-lobe graft is selected, the GV is often less than 40% of the SLV; therefore, for LDALT, right-lobe liver transplantation was introduced, and this trend has grown rapidly.9-15