Adult living donor liver transplant

Given the shortage of available organs, living donor liver transplant is an alternative to be considered, particularly for international patients.

The Cliniques Universitaires Saint-Luc have more than 30 years’ experience of liver transplantation. Between 1984 and 2017, more than 1,300 adult liver transplants were carried out here. 

Given the growing number of candidate patients for transplants and the shortage of available organs, innovative techniques such as living donor liver transplantation (LDLT) have been developed. It is the anatomical and regenerative characteristics of the liver that make this possible.

It is not possible for international patients suffering from liver disease who need a transplant to be registered on the Eurotransplant waiting list (1). LDLT is therefore the only option for these patients. In 2017, around a hundred such procedures were carried out at the Cliniques Universitaires Saint-Luc.

Strict donor selection

Liver transplant is a complex operation which requires strict selection of the recipient and even more so of the donor.

In the majority of cases, the donor is a family member. An unrelated donor may also be considered, subject to the approval of the Ethics Committee. In liver transplants, only the blood group is crucial. However, it is possible to carry out “ABO-incompatible” transplants where there is no donor with the same blood group.

In all cases, the potential donor must first undergo an exhaustive health check (some examinations can be carried out in the country of origin). After this, donation-specific examinations are carried out. The volume and anatomical characteristics of the donor’s liver are studied in minute detail. The surgical strategy (ie whether to remove the left or right side of the liver) is determined on a case by case basis. The aim of this personalised approach it to ensure that the transplant can be carried out with the least possible risk to both donor and recipient.

Monitoring of international patients

If there are no complications, the donor remains hospitalised for around ten days. For the recipient, the period in hospital is longer: 3 weeks on average.

• Regular monitoring of the donor is required to ensure a good postsurgical outcome in the medium and long term. Blood tests are carried out for several months. A liver MRI scan is also conducted at the Cliniques Universitaires Saint-Luc, 6 months after the procedure. The purpose of this is to evaluate regeneration of the remaining liver and exclude any complications.
• Follow-up of the recipient continues throughout their life (particularly their antirejection therapy) jointly with a hepatologist. Blood tests for international patients can be carried out in the country of origin but the annual health check (imaging and liver biopsy) takes place at the Cliniques Universitaires Saint-Luc.

• Eurotransplant covers 8 European countries and is responsible for the allocation of organs in the transplant centres of these countries.