Altruistic liver donation in the Netherlands

M.T. de Boer, C.I. Buis, A.M. Roelofs, A.P. van den Berg

Thursday 14 march 2019

13:45 - 13:47h at Tropentheater

Categories: Klinisch/Basaal, Parallelsessie

Parallel session: Parallelsessie XV – Basaal / Klinisch 2

Background: Living donor liver transplantation (LDLT) in the pediatric program was started in our centre in 2004 because of a growing shortage of suitable postmortal donor liver grafts. Altruistic liver donation is controversial and in some countries not allowed. In 2010 the first potential altruistic donor in our center was screened. It took 6 months to agree on donation, mainly because of ethical concerns, but after extensive screening no contraindications for donation were found. The liver was accepted for a child who did not have a parent suitable for donation. This procedure was successfully performed anonymously. Despite preoperative concerns we also saw an advantage for the parents who repeatedly reported their gratitude that they both could take care of their sick child. This study aims to compare outcome between altruistic non-directed and related living liver donation.

Methods: Donor and recipient parameters were collected from our prospectively maintained living donor database.

Results: So far, 60 LDLT procedures were performed. Six procedures (10%) were performed in altruistic donors. Median follow up was 267 days. Altruistic donors were significantly older than related donors (50 vs 34 yrs old). Previously 5 out of 6 donors already donated a kidney anonymously, but the liver donation did not have impact on their kidney function. Complication rate was statistically similar in both altruistic (0% gr 3 Clavien Dindo) and related donors (4%). Recipient outcome was also similar in both groups.

Conclusions: This study shows that the donor and recipient outcome after altruistic non-directed left lateral liver donation is good without increased risks in donor or recipient, despite the fact that the donor is older and has a more extensive medical history.