TY - JOUR
T1 - Developing an Adult Living Donor Liver Transplant Program in Western Europe
T2 - The Rotterdam Experience
AU - Chorley, Alicia Jane
AU - Polak, Wojciech G.
AU - Tran, Khe C.K.
AU - Terkivatan, Turkan
AU - Kissler, Jenny
AU - Doukas, Michail
AU - Den Hoed, Caroline
AU - Thomeer, Maarten G.
AU - Dwarkasing, Roy
AU - Metselaar, Herold
AU - Ijzermans, Jan N.M.
AU - Porte, Robert J.
AU - Kuipers, Ernst Johan
AU - Minnee, Robert C.
AU - Boehnert, Markus
N1 - Publisher Copyright:
Copyright © 2025 Chorley, Polak, Tran, Terkivatan, Kissler, Doukas, Den Hoed, Thomeer, Dwarkasing, Metselaar, Ijzermans, Porte, Kuipers, Minnee and Boehnert.
PY - 2025
Y1 - 2025
N2 - Liver transplantation (LT) is curative for end stage liver disease. Expanding LT indications with limited deceased donor grafts has created organ shortages. Living donor liver transplant (LDLT) increases available organs. In 2019, we restarted our adult LDLT program. We describe our steps to create a successful LDLT program, and our outcomes. Critical steps of program development included market analysis, creation of protocols based on best care practices and a rigorous education program. Patients and donors were then actively recruited for LDLT. Outcomes were measured as morbidity (≥3 on the Clavien-Dindo grading system) and mortality. Between January 2019 and August 2024, 54 LDLT were performed. 2 (3%) donors experienced grade 3A and 7 (12%) donors experience grade 3B complications. There was no donor mortality. 22 (41%) patients were transplanted for PSC, the average MELD score was 13 (6–32). 35 (65%) patients had Roux-en-Y reconstructions. 25 (46%) complications were experienced in 22 (40%) patients, there were 2 recipient deaths. Patient and graft survival after LDLT was 97% and 97%, respectively. This paper reported the successful establishment of a LDLT program in the Netherlands. Establishing a LDLT program brings its own unique challenges, with careful planning and persistence, these challenges can be overcome.
AB - Liver transplantation (LT) is curative for end stage liver disease. Expanding LT indications with limited deceased donor grafts has created organ shortages. Living donor liver transplant (LDLT) increases available organs. In 2019, we restarted our adult LDLT program. We describe our steps to create a successful LDLT program, and our outcomes. Critical steps of program development included market analysis, creation of protocols based on best care practices and a rigorous education program. Patients and donors were then actively recruited for LDLT. Outcomes were measured as morbidity (≥3 on the Clavien-Dindo grading system) and mortality. Between January 2019 and August 2024, 54 LDLT were performed. 2 (3%) donors experienced grade 3A and 7 (12%) donors experience grade 3B complications. There was no donor mortality. 22 (41%) patients were transplanted for PSC, the average MELD score was 13 (6–32). 35 (65%) patients had Roux-en-Y reconstructions. 25 (46%) complications were experienced in 22 (40%) patients, there were 2 recipient deaths. Patient and graft survival after LDLT was 97% and 97%, respectively. This paper reported the successful establishment of a LDLT program in the Netherlands. Establishing a LDLT program brings its own unique challenges, with careful planning and persistence, these challenges can be overcome.
KW - live donor liver transplant
KW - liver donation
KW - liver transplant
KW - living donor liver transplantation (LDLT)
KW - living liver donation
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U2 - 10.3389/ti.2025.14442
DO - 10.3389/ti.2025.14442
M3 - Article
AN - SCOPUS:105011356710
SN - 0934-0874
VL - 38
JO - Transplant International
JF - Transplant International
M1 - 14442
ER -