Adult-to-adult living donor liver transplantation in acute liver failure

Background: Living Donor Liver Transplantation(LDLT) in acute liver failure(ALF) patients has been limited by concerns regarding donor safety, consent process and recipient outcomes. Our objective was to conduct a systematic review(SR) and meta-analysis to address the concerns about subpar LDLT outcomes in patients with ALF.Methods: We retrieved a total of 5965 literature references in our SR. United Network for Organ Sharing (UNOS) database was queried for patients over the age of 18, who underwent LDLT for status 1 or status 1A listing.Results: Of 427 articles reviewed, 3 studies comprising 2574 patients (192 underwent LDLT and 2382 DDLT), were included in the meta-analysis. One, 3,5-year patient and graft survival demonstrated no difference between LDLT and DDLT group: 1-year patient survival OR1.51; 95%CI [0.58,1.90]; 1-year graft survival OR 1.19; 95%CI [0.65-2.18]; 3-year patient survival OR 0.97;95%CI [0.52-1.88]; 3-year graft survival OR 1.21 95%CI [0.67-2.16]; 5-year patient survival 0.9; 95%CI [0.37-2.20]; 5-year graft survival OR 1.30; 95%CI [0.57-2.97]. UNOS database search returned only 3 patients that underwent LDLT for ALF compared to 1562 with DDLT, precluding comparison.Conclusion: One, 3, and 5-year patient and graft survival following LDLT vs DDLT transplantation were not statistically significantly different; however, due to limited number of studies further studies are warranted.

Automated summary

This study conducted a systematic review and meta-analysis to address concerns regarding subpar outcomes of living donor liver transplantation (LDLT) in patients with acute liver failure (ALF). The results showed no significant difference in 1, 3, and 5-year patient and graft survival between LDLT and deceased donor liver transplantation (DDLT). However, further studies are warranted due to the limited number of included studies.