Right lobe living: Donor liver transplantation

Background, The shortage of livers for transplantation has prompted transpl ant centers to seek alternatives to conventional cadaveric liver transplant ation, Left lateral segmentectomy from living donors has proven to be a saf e operation for the donor with excellent results in the pediatric populatio n. Left lobectomy, conceived to supply more tissue, still provides insuffic ient liver mass for an average size adult patient. Right lobectomy could su pply a graft of adequate size. Methods. Donors were considered only after recipients were listed according to United Network for Organ Sharing (UNOS) criteria. Donor evaluation incl uded liver biopsy, magnetic resonance imaging, and celiac and mesenteric an giography. The donor operation consisted of a light lobectomy uniformly per formed throughout the series as described herein. Results. Twenty-five right lobe living donor liver transplants were perform ed between adults, with no significant complications in donors. Recipient a nd graft survival was 88%, with three recipient deaths secondary to uncontr olled sepsis in patients at high risk for liver transplant; all three had f unctioning grafts. Conclusions. Right lohe living donor liver transplantation poses challenges that require a meticulous surgical technique to minimize morbidity in the recipient. Right lobectomies for living donation can be performed safely wi th minimal risk to both donor and recipient although providing adequate liv er mass for an average size adult patient.