ArticleAnnals of surgery2023
Novel Benchmark for Adult-to-Adult Living-donor Liver Transplantation: Integrating Eastern and Western Experiences.
Article in Annals of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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16 citing papers in PubMed, 26 citations in OpenAlex.
- Article
- Living Donor Training During ASTS Fellowship: Disparities in Autonomy Between Kidney and Liver Donation. A National Survey.Clinical transplantation · 2026Article
- Triangular anastomosis enhances early patency of small middle hepatic vein tributaries in right lobe living donor liver transplantation.Langenbeck's archives of surgery · 2026Article
- Outcome reporting for liver transplantation machine perfusion studies: a systematic review.EClinicalMedicine · 2026Review
- Outcomes of 6000 living donor liver transplantation procedures: a pioneering experience at ASAN Medical Center.Updates in surgery · 2025Article
- Advocating for a "shift-to-left" in transplant oncology: left grafts, RAPID and dual graft.Updates in surgery · 2025Review
- Technical note: biliary reconstruction in living-donor liver transplant.Updates in surgery · 2025Article
- Liver Transplantation Using Allografts With Hepatic Artery Injury During Procurement: A Propensity Score-Matched Analysis of Outcomes.Clinical transplantation · 2025Article
- SBRT for bridging and downstaging HCC before transplant.JHEP reports : innovation in hepatology · 2025Article
- Defining benchmark values for outcomes of comprehensive resection of primary retroperitoneal liposarcoma: a retrospective multicenter study.EClinicalMedicine · 2025Article
- Recipient 3-Hepatic Vein Technique with Graft Venoplasty to Maximize Venous Outflow in Left Lobe Living Donor Liver Transplantation.Transplantation direct · 2025Article
- Benchmark center volume and regional disparity in living donor liver transplantation.Hepatobiliary surgery and nutrition · 2025Article
- Effect of Complex Venous Outflow Drainage Reconstruction on Postoperative Graft Function in Right-Lobe Living Donor Liver Transplantation.Journal of clinical medicine · 2025Article
- Living Donor Liver Transplantation with Small Left Lobe Grafts: Prospective Validation of Utility of Splenectomy in Selected Recipients.Annals of transplantation · 2025Article
- Factors Affecting Intraoperative Blood Transfusion Requirements during Living Donor Liver Transplantation.Journal of clinical medicine · 2024Article
- 6,126 hepatectomies in 2022: current trend of outcome in Italy.Langenbeck's archives of surgery · 2024Observational
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Authors and funding
41 authors at 17 institutions in 13 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo define benchmark values for adult-to-adult living-donor liver transplantation (LDLT).
backgroundLDLT utilizes living-donor hemiliver grafts to expand the donor pool and reduce waitlist mortality. Although references have been established for donor hepatectomy, no such information exists for recipients to enable conclusive quality and comparative assessments.
methodsPatients undergoing LDLT were analyzed in 15 high-volume centers (≥10 cases/year) from 3 continents over 5 years (2016-2020), with a minimum follow-up of 1 year. Benchmark criteria included a Model for End-stage Liver Disease ≤20, no portal vein thrombosis, no previous major abdominal surgery, no renal replacement therapy, no acute liver failure, and no intensive care unit admission. Benchmark cutoffs were derived from the 75th percentile of all centers' medians.
resultsOf 3636 patients, 1864 (51%) qualified as benchmark cases. Benchmark cutoffs, including posttransplant dialysis (≤4%), primary nonfunction (≤0.9%), nonanastomotic strictures (≤0.2%), graft loss (≤7.7%), and redo-liver transplantation (LT) (≤3.6%), at 1-year were below the deceased donor LT benchmarks. Bile leak (≤12.4%), hepatic artery thrombosis (≤5.1%), and Comprehensive Complication Index (CCI ® ) (≤56) were above the deceased donor LT benchmarks, whereas mortality (≤9.1%) was comparable. The right hemiliver graft, compared with the left, was associated with a lower CCI ® score (34 vs 21, P < 0.001). Preservation of the middle hepatic vein with the right hemiliver graft had no impact neither on the recipient nor on the donor outcome. Asian centers outperformed other centers with CCI ® score (21 vs 47, P < 0.001), graft loss (3.0% vs 6.5%, P = 0.002), and redo-LT rates (1.0% vs 2.5%, P = 0.029). In contrast, non-benchmark low-volume centers displayed inferior outcomes, such as bile leak (15.2%), hepatic artery thrombosis (15.2%), or redo-LT (6.5%).
conclusionsBenchmark LDLT offers a valuable alternative to reduce waitlist mortality. Exchange of expertise, public awareness, and centralization policy are, however, mandatory to achieve benchmark outcomes worldwide.
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