Which works better in liver transplants – transplanting a portion of a liver donated from a living donor or transplanting an entrie organ donated from a deceased person?

Retrospective studies have suggested that graft survival in right – lobe living donor liver transplantation was inferior to cadaveric liver transplantation. This was blamed on small graft size. However, Dr. Sheung Tat Fan and others at the university of Hong Kong carried out at a prospective study of the two procedures within a single center. This was reported in the Annals of Surgery . They compared outcomes for adults treated between 2000 and 2004 at Queen Mary Hospital. Included were 124 patients who underwent right lobe  living donor liver transplantation and 56 who underwent cadaveric whole- graft liver transplantation.

According to the team, there were no marked difference between the two groups in trem of length of hospital or ICU stay or deaths occurring before hospital discharge. After a median follow – up of 27 months in the living donor group and 25 months in the cadaver donor group, corresponding patient survival was 90 percent and 84 percent. During the same period, the morality rate of patient on the wait list was 43 percent.

The only significant difference between the groups the incidence of bile duct narrowing – 25 percent in the living donor group and 5 percent in the living cadaveric donor group. This complication was treated successfully with a variety of techniques including stenting and did not affect the survival of the graft or the patient.

Fan’s team also point out that none of the individuals who donated parts of their liver died or required any transfusion and complication in the live donors that did arise were successfully managed.

This study, the team concludes, does not support past studies that have suggested that partial live donor liver transplantation is less effective than cadaveric whole – organ liver transplantation. Partial liver grafts “should not be considered as marginal grafts”, they say.