Living donor liver transplantation in adults in the MELD era in Germany

[Clark]

http://onlinelibrary.wiley.com/doi/10.1111/j.1432-2277.2011.01283.x/abstract

Living donor liver transplantation in adults in the MELD era in Germany – a multi-center retrospective analysis
Utz Settmacher1, Max Götz1, Axel Rahmel2, Erik Bärthel1, Hans Schlitt3, Gero Puhl4, Dieter Broering5, Frank Lehner6, Lutz Fischer7, Andreas Paul8, Jan Schmidt9, Silvio Nadalin10, Aiman Obed11, Michael Heise1
Article first published online: 11 JUN 2011

DOI: 10.1111/j.1432-2277.2011.01283.x

Transplant International

Abstract
The aim of this analysis was to provide an update on the current trend in living donor liver transplantation (LDLT) for adult recipients in the model of end stage liver disease (MELD) era in Germany and to encourage a wider implementation of LDLT. We descriptively analysed the data of LDLTs in Germany from 15 December 2006 to 31 December 2009 using a multi-center retrospective analysis via a questionnaire and data provided by Eurotransplant. Ten German centers performed LDLTs in adults. Eighty four transplantations in 50 male recipients and 34 female recipients were performed during the review period, ranging from 1 to 16 LDLTs per center. Hepatocellular carcinoma in cirrhosis (15/84) was the most common transplantation indication. The recipient mean lab-MELD score was 15 (±8). Six re-transplantations were necessary after initial LDLTs. The 1-year patient survival was 81%. We obtained data of 79/84 donors. The incidence of complications was 30.4% (n = 24). There were no grade 5 complications according to the Clavien classification. LDLT is an established treatment option that may reduce the waiting time, provides high quality split liver grafts and should be advocated in the MELD era to reduce organ shortage and ‘death on the waiting list’.