Liver transplantation, living-donor liver donation and split liver transplantation

The tasks of the liver, which is the most important and the largest metabolic organ of the human body, encompass, among others, the decomposition and elimination of substances, the production of vital proteins, and the absorption of nutrients. The most frequent liver diseases – where liver transplantation is often the only option for patients – include malignant tumours, infectious hepatitis, intoxications, diseases of the biliary tract, metabolic disorders, scarring of the entire liver (liver cirrhosis), or alcohol-induced liver damage (alcohol cirrhosis). As with kidney diseases, the time until transplantation can be bridged by means of a dialysis procedure. In a few cases, the liver regenerates itself and transplantation can be avoided. The world’s first human liver transplantation was performed on a three-year-old child in the USA on 1 March 1963.
Besides post-mortal donation of a whole liver, living-donor liver donation and split liver transplantation are other techniques used in modern medicine. Split liver transplantation involves the division of a donor organ into a left and a right segment in such a way that preserves the essential structures of the hepatic hilum with the liver artery, portal vein and bile ducts on both sides and allows an anatomically exact separation of the draining veins. Provided that the relation between size of the liver and body height is taken into account, one donor organ may benefit two patients. However, since the rate of complications following split liver transplantation is high – even in cases where very good donor organs (age factor) are used – the procedure has not yet become standard practice.
The technique of split liver transplantation has led to the development of living-donor liver donation and transplantation where the right or left part of a healthy liver is removed from a living organ donor and transplanted into a recipient. This procedure is mainly used with paediatric patients who suffer from hereditary enzyme deficiency or bile duct atresia and for whom transplantation of the left lobe of a parent’s liver often represents the only therapeutic option when a suitable donor organ from a deceased donor cannot be supplied in time.

Information on liver transplantation provided by the University Hospital Charité in Berlin Online Version (German)

Lebertransplantierte Deutschland e.V. Online Version (German)

Further information on the website of the DSO Online Version

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