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Outcomes of 6000 living donor liver transplantation procedures: a pioneering experience at ASAN Medical Center

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Abstract

Living donor liver transplantation (LDLT) has emerged as a favorable alternative to deceased donor liver transplantation, significantly reducing waitlist mortality, particularly in Asian countries with very low deceased organ donation rates. Asan Medical Center (AMC) in South Korea has pioneered innovative LDLT surgical techniques and become established as an extremely high-volume center for LDLT. This retrospective study analyzed 6000 consecutive LDLT procedures, including 510 dual-graft procedures, performed at AMC between December 1994 and January 2021. Of these, 312 LDLT procedures were performed in children aged < 18 years. In adult recipients, liver cirrhosis (LC) related to viral hepatitis was the most common indication, occurring in 69.8% of cases. Biliary atresia (46.8%) was the most common indication for pediatric LDLT. This study demonstrated outstanding long-term outcomes, with patient survival rates at 1, 5, 10, and 20 years of 92.7%, 85.9%, 82.1%, and 70.9%, respectively, in LDLT group for adults aged 50 and under at the time of LDLT, and 92.9%, 89.0%, 88.1%, and 81.9%, respectively, in the pediatric group. The in-hospital mortality rate of adult recipients was 3.8% (n = 214/5688). This study demonstrates the importance of refined surgical techniques, selection of grafts tailored to the recipient, and comprehensive multidisciplinary perioperative patient care in expanding the scope of LDLT and improving recipient outcomes.

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Data availability

The data presented in this study are available upon request from the corresponding author. The data are not publicly available due to privacy and ethical restrictions.

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Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap-dong, Songpa-gu, Seoul, 138-736, South Korea

    Young-In Yoon, Ki-Hun Kim, Shin Hwang, Chul-Soo Ahn, Deok-Bog Moon, Tae-Yong Ha, Gi-Won Song & Sung-Gyu Lee

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  1. Young-In Yoon
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  2. Ki-Hun Kim
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  3. Shin Hwang
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  4. Chul-Soo Ahn
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  5. Deok-Bog Moon
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  6. Tae-Yong Ha
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  7. Gi-Won Song
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  8. Sung-Gyu Lee
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Contributions

All authors contributed to the study conception and design. Patients and data collection was performed by Young-In Yoon, Tae-Yong Ha, Gi-Won Song. Data analysis was performed by Shin Hwang, Chul-Soo Ahn, Deok-Bog Moon. The first draft of the manuscript was written by Young-In Yoon, Ki-Hun Kim, Sung-Gyu Lee. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ki-Hun Kim.

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Conflict of interests

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study was approved by the Institutional Review Board of Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (approval number 2023–1436) and conducted in accordance with the principles outlined in the Declaration of Helsinki.

Consent to participate

The need for an informed consent was waived due to the retrospective nature of the study.

Research involving human participants and/or animals, and Informed consent

Ethics committee approval and written consent to participate in the study were not required because this was a retrospective review of de-identified patient data from a public database.

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Yoon, YI., Kim, KH., Hwang, S. et al. Outcomes of 6000 living donor liver transplantation procedures: a pioneering experience at ASAN Medical Center. Updates Surg (2024). https://doi.org/10.1007/s13304-024-01807-5

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