Liver Transplantation for primary liver cancer part 2 (Living donor Liver transplant)

We have discussed about criteria and indications for cadaveric or brain death liver transplantation.

In countries like India and other Asian countries where organs from brain dead donor are available rarely, we must think of living donor liver transplants.

As we have seen in the previous post that living donation is a personal gift particularly for India where only relatives can donate the organ. For unrelated to give organs it requires huge legal work and mostly not possible, It becomes more of a family affair.

So can we deny when a person has willing donor and ready to take all the risk if he does not fulfill the criteria and cancer has not spread to any other organ. Well there is ongoing debate about this.

In other Asian countries some follow strict criteria like UCSF or some have their own criteria.

But mostly if cancer is too many in number or huge in size, success of liver transplant is not that much. I.e. most patients will come back with recurrent. So Huge cost of liver transplant is wasted and a healthy person undergoes unnecessary major surgery.

So decision for living donor liver transplant has to be taken on patient-to-patient bases, keeping in mind logistics also. Generally it is believed that if surgeon feels that after transplant there are 50% chance of surviving more than 5 years then a transplant is a feasible option.

One way is assess tumor biology either by biopsy or time of tumor progression etc if tumor biology is good and person has willing donor one can go ahead with living donor transplant with keeping in mind risks involved.

But in countries like India where brain dead donors are rarely available, and person fulfills the criteria mention in previous post, person should immediately think about living donor liver transplant.

Living Donor Liver Transplantation