Editorial: How close can we get to the edge of the cliff? (Living Liver Donors)

[Clark]

http://onlinelibrary.wiley.com/doi/10.1111/ajt.13686/abstract

Editorial
How close can we get to the edge of the cliff?
Hiroto Egawa
DOI: 10.1111/ajt.13686
American Journal of Transplantation
Accepted Article (Accepted, unedited articles published online and citable. The final edited and typeset version of record will appear in future.)

Abstract
Living donor liver transplantation (LDLT) was developed to solve the problem of donor scarcity, initially for pediatric patients. As one of the strategies to expand the donor pool, blood type-incompatible liver transplantation was developed (1). This has nothing to do with donor safety. The expansion of LDLT to adult patients created the need to overcome small-for-size syndrome. To obtain a larger volume, innovations such as the left lobe graft with the caudate lobe, the right lobe graft, and the extended right lobe graft were developed. Dual graft LDLT was also developed in Korea. To obtain optimal blood flow for small grafts, outflow reconstruction and portal flow modulation were developed to overcome small-for-size syndrome.