Over the last 20 years liver transplantation has become the standard of care and the only cure for end stage liver disease. Its success has led to over 4,500 transplants performed yearly. But there are at least 18,000 patients on the transplantation list awaiting cadaveric liver donation. As the waiting list has expanded, waiting time has also grown. As a result, patient mortality has increased while awaiting transplantation and patients are often critically ill by the time of transplantation. Among possible remedies, adult to adult living donor liver transplantation (AALDLT) has become widely accepted for pediatric transplantation. AALDLT is a more challenging procedure and has potentially greater risk to the donor because of the larger portion of liver that is required. Although still a small number relative to the several thousand adult cadaveric liver transplants performed annually, AALDLT has the potential for changing the face of liver transplantation.
AALDLT is a relatively new procedure increasingly used at major transplantation centers. Too few cases are performed at any one center and approaches to the patient and donor are too diverse across centers to provided generalizable information on donor and recipient outcomes from individual centers. The primary goal of this study will be to provide valuable information on the outcomes of AALDLT. This information is needed to aid decisions made by physicians, patients, and potential donors. The study will establish and maintain the infrastructure required to accrue and follow sufficient numbers of patients being considered for and undergoing AALDLT to provide generalizable data from adequately powered studies. (Jean Emond, MD)