Risk factors of hepatic graft failure, morbidity and mortality after living donor liver transplantation (LDLT): Review Article

Abstract

Back ground: Liver transplantation is a breakthrough in the modern life. With the increase demands on liver transplantation, LDLT was emerged. With more increase in the demands, the donor pool started to be widened and the use of marginal donors started. The factors affect the graft failure become widened and included multiple factors. Aim and objective: This review extensively put the focus on the risk factors for hepatic graft failure after LDLT. Also, the impact of these factors and their influence on the patients' morbidity and mortality. Conclusion: Multiple factors were studied as risk factors for graft failure and patients' mortality after LDLT. The rate of early graft failure is low. This is due to optimum donor selection as regards age, sex, body mass index (BMI) and ABO-compatibility; computer-assisted planning and decision making in donor segmental hepatectomy and optimum GRWR; short cold ischemic time; high level of expertise in the center; and timely detection of vascular, biliary and immunological complications responsible for early graft failure together with early and efficient management. Most of the underlying risk factors for late graft failure include patients with CR which were not responding to treatment and patients with disease recurrence which is unavoidable. Therefore, both these complications constitute real problems in liver transplantation.