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Home > Divisions > Transplantation > Living Donor Liver Transplant > Introduction
Introduction
The liver is a very important organ in the body.
It performs three major tasks. First, from digested food,
it makes proteins that are needed to nourish the body, fight
infections, and stop bleeding. Second, it helps the body
to rid of wastes, including ammonia, bilirubin, other waste
products of natural liver function, and many drugs. Third,
the liver excretes bile, which helps digest dietary fats.
When the liver fails and does not adequately perform these
tasks, a transplant is necessary. A liver transplant is
a major surgical operation in which the diseased liver is
taken out of the recipient's body and replaced with a healthy
one from either a cadaver or living donor.
Liver transplantation has been successfully done since the
early 1980s. At first, all donors came from a cadaver, someone
who has died and donated his or her organs. Better surgical
techniques and advancements in immunosuppression improved
success rates and allowed more patients with liver disease
to be potentially treated with a liver transplant. Unfortunately,
this expansion has led to a marked shortage in cadaver donor
organs and greatly lengthened the time that recipients must
wait for a liver transplant. Consequently, as the waiting
list has grown, so has the number of people dying while
waiting for a transplant.
In an attempt to expand the donor pool, physicians are now
exploring the use of living organ donors. Living donations
are most common for kidney transplants , but are also now
an option for liver transplants. Pieces of the liver (one
of the two lobes, or even a smaller segment) can be successfully
removed from a living donor and transplanted into a recipient.
The first living donor liver transplant (LDLT) in the United
States was performed in 1989 when a child received a segment
of his mother's liver. Since that time, over 1,500 LDLTs
have been performed for children across the nation, with
excellent success rates.
Surgeons in Japan were the first to demonstrate that an
even larger piece of the liver (one of the two lobes) could
safely be removed from a living adult donor and transplanted
into another adult. This operation, while more technically
difficult than living liver donation for pediatric recipients,
also proved to be successful. Only a handful of centers
in the United States currently perform adult-to-adult LDLTs.
As of March 2000, about 200 such transplants have been performed
in the United States. Preliminary results have been good.
Since 1996, our transplant team at the University of Minnesota
has been performing LDLTs at University of Minnesota Medical
Center, Fairview, in Minneapolis, Minnesota. The first adult-to-child
LDLT and the first adult-to adult LDLT in Minnesota were
both performed here. We now offer LDLT as an option to the
majority of children and adults referred to us for a liver
transplant.
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