Technical Tips and Tricks for Living Donations

Abstract

Adult right-lobe living-donor liver transplantation is a technically demanding operation. Since it was conducted for the first time in 1996, its application has been expanding tremendously and it has become the mainstay at most Asian liver transplant centers. This is the result of its success rate for both donors and recipients and because it has helped alleviated the severe shortage of deceased-donor liver grafts. Improved understanding of the anatomy of the liver and advances in surgical techniques has dramatically reduced the complication rates. Recipients now can have excellent long-term survival, while the risks borne by the donors are acceptable. This article presents the surgical tips and tricks for donor right hepatectomy, the back-table procedure and recipient operation. The management of small-for-size liver grafts and methods of biliary reconstruction are also discussed.