The following is an excerpt from an article published in The Conversation and authored by McGowan Institute for Regenerative Medicine affiliated faculty member Abhinav Humar, MD, Clinical Director of the Thomas E. Starzl Transplantation Institute and the Chief, Division of Transplantation in the Department of Surgery at the University of Pittsburgh Medical Center. He is also a Professor in the Department of Surgery at the University of Pittsburgh School of Medicine and a Staff Physician at the Pittsburgh VA Medical Healthcare System. Read the entire article here.
While most livers for transplant in the U.S. come from deceased donors, a major advance has occurred in recent years. It now is possible for a surgeon to take a portion of a liver from an otherwise healthy individual and use that for transplant. The procedure started first in children, with the first U.S. transplant in 1989. It then expanded for use in adults by 1996. The availability of a living donor obviates the need for someone to wait, and, therefore, potentially limits the likelihood a person will die while waiting for a liver.
Live liver transplantation allows patients to receive a transplant from a living donor as soon as they are deemed ready for a transplant. This is often a point sooner in the disease process, when they are healthier and better able to tolerate the procedure. This leads to a quicker and less complicated recovery. Additionally, patients who are not eligible for a transplant from a deceased donor can still receive a transplant from a living donor if there is a survival benefit.
Despite the advantages, living donor liver transplants in the U.S. account for less than 5 percent of all liver transplants. In other countries, such as Korea, Japan and India, living donor liver transplants account for almost 90 percent of liver transplants.
The main reason for the underutilization is a lack of awareness of the procedure, both by patients and the health care community. At UPMC, we strongly believe in the ability of living donor liver transplant to be a lifesaving procedure and offer this as a first-line option to all our patients in need of a liver transplant.
We perform the most living donor liver transplants in the country, and for the first time ever, in 2017, performed more transplants from living than deceased donors.
The bottom line is that living donor liver transplant represents a lifesaving option for all patients with liver failure, offering numerous advantages over the option of waiting for a deceased donor. In my view, all patients in need of a liver transplant should be made aware of this procedure and, in almost every case, be offered a transplant from a live donor as the first option. With this change, many more lives could be saved every year.