Question: What is the current status of living donor liver transplants, is it the preferred method for infants or is it the second choice? How do survival rates compare between living donor liver transplants and cadaveric transplants?

Answer: The status of living donor liver transplantation is still controversial in this country. Those in favor of living-related liver transplantation point to slightly higher patient survival rates in published reports compared to average cadaver liver transplantation. (But this issue hasn't been studied very well).

Advocates also claim an advantage in transplanting patients while they are still stable, since while waiting a year or more for a cadaver liver the patient may become sicker, making the transplant riskier. Also, using living donors increases the total supply of livers.

The critics of living related transplantation point to the risk to the donor (there has been at least one death of a donor in Europe, and one in the United States), and the higher rate of reoperation and other surgical complications in living donor compared to cadaver donor liver transplants. Also, most children that are referred early for liver transplant tolerate the wait for a cadaveric organ fairly well.
-Jeffrey Punch, MD