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Living-Related Organ Transplantations

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Anesthesia and Perioperative Care for Organ Transplantation

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Abstract

The high incidence of end-stage organ failure and the inadequate supply of cadaveric organs increases the gap between organ availability and organ demand, resulting in prolonged waiting times, and consequently, elevated mortality on the waiting list. Living donation emerges therefore as a potential source to overcome organ shortage. Donor safety, however, is clearly the major concern in living-donor transplantation, as individuals who are willing to donate are exposed to surgical procedures that pose risks and offer no physical benefits.

While specific benefits for the recipients have been ascertained for some living-related transplantations, in the case of other organs, neither short- nor long-term functional outcomes have proven to be superior to organ transplantation from deceased donors. In critically ill children and in those with end-stage disease, living donation is a feasible option, due to both short- and long-term favorable outcomes.

Careful candidate evaluation and selection, along with periprocedural care by a qualified, expert team are crucial to face the major concerns regarding donor morbidity and mortality.

Various issues of living-related organ transplantation are still under stringent debate, and the future of this procedure will probably depend on the ability to improve physical and psychological donor outcomes, the precise determination of outcomes for specific pathologic entities, the improvement of recipient survival, and the field’s financial growth margin.

Given the small number of living transplantations, apart from living donor kidney transplant, it is preferable to concentrate the performance of these procedures in a few excellent centers, since center experience leads to better results.

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Authors and Affiliations

  1. Department of Medicine UO Anesthesia and Intensive Care, University Hospital of Padova, Via Cesare Battisti, 256, 35128, Padova, Italy

    Paolo Feltracco M.D. & Carlo Ori M.D.

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  1. Paolo Feltracco M.D.
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  2. Carlo Ori M.D.
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Correspondence to Paolo Feltracco M.D. .

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Editors and Affiliations

  1. Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

    Kathirvel Subramaniam

  2. Department of Anesthesiology The Clinical and Translational Science Institute The McGowan Institute for Regenerative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

    Tetsuro Sakai

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Feltracco, P., Ori, C. (2017). Living-Related Organ Transplantations. In: Subramaniam, K., Sakai, T. (eds) Anesthesia and Perioperative Care for Organ Transplantation. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-6377-5_4

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  • DOI: https://doi.org/10.1007/978-1-4939-6377-5_4

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