Perioperative management of living donor liver transplantation: Part 2 - Donors
Authors
Tetsuro Sakai ; Justin Sangwook Ko ; Cara E Crouch ; Sathish Kumar ; Gyu-Seong Choi ; Florian Hackl ; Dai Hoon Han ; Michael Kaufman ; Seong Hoon Kim ; Carla Luzzi ; Stuart McCluskey ; Won Jung Shin ; Joel Sirianni ; Ki Won Song ; Cinnamon Sullivan ; Adrian Hendrickse
Adult ; End Stage Liver Disease* / surgery ; Hepatectomy / methods ; Humans ; Liver Transplantation* / methods ; Living Donors ; Tissue and Organ Harvesting
Keywords
KSTA ; SATA ; anesthesia ; donor ; liver transplantation ; living donor liver transplantation ; review
Abstract
Living donor liver transplantation was first developed to mitigate the limited access to deceased donor organs in Asia in the 1990s. This alternative liver transplantation method has become a widely practiced and established transplantation option for adult patients suffering with end-stage liver disease, and it has successfully helped address the shortage of deceased donors. The Society for the Advancement of Transplant Anesthesia and the Korean Society of Transplantation Anesthesiologists jointly reviewed published studies on the perioperative management of adult live liver donors undergoing donor hemi-hepatectomy. The goal of the review is to offer transplant anesthesiologists and critical care physicians a comprehensive overview of the perioperative management of adult live donors. We featured the current status, donor selection process, outcomes and complications, surgical procedure, anesthetic management, Enhanced Recovery After Surgery protocols, avoidance of blood transfusion, and considerations for emergency donation. Recent surgical advances, including laparoscopic donor hemi-hepatectomy and robotic laparoscopic donor surgery, are also addressed.