Postoperative outcomes in living donor liver transplant

Background: The incidence of metabolic dysfunction-associated steatotic liver disease (MASLD) and progression to metabolic dysfunction-associated steatohepatitis (MASH) is increasing concomitantly with the obesity epidemic. MASH is now one of the leading reasons for liver transplant in the United States. As such, living donor liver transplant (LDLT) holds promise to provide these increasingly medically complex patients with timely access to transplantation. The goal of this study was to compare outcomes between LDLT and deceased donor liver transplant (DDLT) in this patient population. Methods: We performed a retrospective study using United Network for Organ Sharing Standard Transplant Analysis and Research (UNOS/STAR) data from 2002 to June 2022 and compared liver transplant outcomes in patients with MASH who underwent LDLT with DDLT. Donor and recipient baseline characteristics, as well as postoperative outcomes including graft and patient survival were analyzed and compared between groups. Results: The proportion of LDLT recipients on dialysis was lower than the proportion of DDLT recipients (1.2% Conclusions: LDLT for patients with MASH allows this medically comorbid patient population safe access to transplantation at an earlier and less decompensated disease stage and lower MELD with improved survival.