Chorley Alicia Jane, Polak Wojciech G, Tran Khe C K, Terkivatan Turkan, Kissler Jenny, Doukas Michail, Den Hoed Caroline, Thomeer Maarten G, Dwarkasing Roy, Metselaar Herold, Ijzermans Jan N M, Porte Robert J, Kuipers Ernst Johan, Minnee Robert C, Boehnert Markus
Division of HPB and Transplant Surgery, Department of Surgery, Erasmus University Medical Centre, Erasmus MC Transplant Institute, Erasmus University Medical Centre, Rotterdam, Netherlands.
Department of Anaesthesiology, Erasmus University Medical Centre, Rotterdam, Netherlands.
Transpl Int. 2025 Jul 10;38:14442. doi: 10.3389/ti.2025.14442. eCollection 2025.
Liver transplantation (LT) is curative for end stage liver disease. Expanding LT indications with limited deceased donor grafts has created organ shortages. Living donor liver transplant (LDLT) increases available organs. In 2019, we restarted our adult LDLT program. We describe our steps to create a successful LDLT program, and our outcomes. Critical steps of program development included market analysis, creation of protocols based on best care practices and a rigorous education program. Patients and donors were then actively recruited for LDLT. Outcomes were measured as morbidity (≥3 on the Clavien-Dindo grading system) and mortality. Between January 2019 and August 2024, 54 LDLT were performed. 2 (3%) donors experienced grade 3A and 7 (12%) donors experience grade 3B complications. There was no donor mortality. 22 (41%) patients were transplanted for PSC, the average MELD score was 13 (6-32). 35 (65%) patients had Roux-en-Y reconstructions. 25 (46%) complications were experienced in 22 (40%) patients, there were 2 recipient deaths. Patient and graft survival after LDLT was 97% and 97%, respectively. This paper reported the successful establishment of a LDLT program in the Netherlands. Establishing a LDLT program brings its own unique challenges, with careful planning and persistence, these challenges can be overcome.
肝移植（LT）是终末期肝病的治愈方法。随着可用的脑死亡供体器官有限，肝移植适应证的扩大导致了器官短缺。活体供肝移植（LDLT）增加了可用器官数量。2019年，我们重启了成人LDLT项目。我们描述了创建一个成功的LDLT项目的步骤以及我们的成果。项目开发的关键步骤包括市场分析、基于最佳护理实践制定方案以及严格的教育项目。然后积极招募患者和供体进行LDLT。以发病率（Clavien-Dindo分级系统中≥3级）和死亡率来衡量结果。在2019年1月至2024年8月期间，共进行了54例LDLT。2例（3%）供体发生3A级并发症，7例（12%）供体发生3B级并发症。无供体死亡。22例（41%）患者因原发性硬化性胆管炎接受移植，平均终末期肝病模型（MELD）评分是13分（6 - 32分）。35例（65%）患者进行了Roux-en-Y重建。22例（40%）患者发生了25例（46%）并发症，有2例受者死亡。LDLT术后患者和移植物存活率分别为97%和97%。本文报道了荷兰一个LDLT项目的成功建立。建立一个LDLT项目有其自身独特的挑战，但通过精心规划和坚持不懈，这些挑战是可以克服的。
