Outcomes of the Initial Phase of an Adult Living versus Deceased Donor Liver Transplantation Program in a Low-volume Transplant Center

Background: The development of living donor liver transplantation (LDLT) is clinically challenging, especially in a low-volume transplant program. We evaluated the short-term outcomes of LDLT and deceased donor liver transplantation (DDLT) to demonstrate the feasibility of performing LDLT in a low-volume transplant/high-volume complex hepatobiliary surgery program during the initial phase. Methods We carried out a retrospective study of LDLT and DDLT in Chiang Mai University Hospital from October 2014 to April 2020. Postoperative complications and one-year survival were compared between the two groups. Results There were 20 LDLT patients and 20 DDLT patients. The operative time and hospital stay were significantly longer in the LDLT group than in the DDLT group. The incidence of complications in both groups was comparable, except for biliary complications, which were higher in the LDLT group. The most common complication in donor is bile leakage which was found in 3 (15%). The one-year survival rates of both groups were also comparable. Conclusion Even during the initial phase of the low-volume transplant program, LDLT and DDLT had comparable perioperative outcomes. Surgical expertise in complex hepatobiliary surgery is necessary to facilitate effective LDLT which has the potential to increase case volumes and lead to program sustainability.