Evaluation of Donor Exclusions for Living Donor Liver Transplantation in a Tertiary Center

Abstract

Introduction. The success of living donor liver transplantation is closely related to donor selection. Living donor liver transplantation (LDLT) plays a crucial role in saving lives, especially where cadaveric donations are limited. Donor selection is pivotal for the success of LDLT, emphasizing donor rights, minimizing complications, and ensuring donor survival. The main purpose for donor evaluation is to provide a suitable graft for the recipient while assuring a safe operation for the donor. This study aims to identify our center's donor exclusion reasons, assess limitations in donor pool utilization, and enhance its effectiveness. Methods. We retrospectively analyzed data from 680 healthy individuals who applied as liver donor candidates to our center between November 2016 and November 2021. Of these, 170 underwent donor hepatectomy, while 510 candidates deemed unsuitable were investigated. Results. A total of 170 (25%) candidates became liver donors (group A), and 510 (75%) candidates were found unsuitable (group B). Recipient-related reasons (179, 35.09%) made up the leading exclusion cause. Psychiatric problems (105, 20%) ranked second among the reasons for rejection of donor candidates, and hepatosteatosis was the third most common reason. Conclusion. The critical factor determining the success of living donor liver transplantation is the precise selection of the donor. Achieving optimal donor selection is feasible through a comprehensive multidisciplinary liver transplant team and clearly defined criteria. By employing appropriate selection standards and a skilled transplant team, it is feasible to enhance the pool of liver donors and conduct more living donor liver transplants with reduced morbidity and mortality rates.