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Dr. Brown Presents First Data on Living Donor Liver Transplant
Procedure shown to be safe for donors and recipients
Robert S. Brown, Jr., MD, MPH is the principal author of an article entitled "A Survey of Liver Transplantation from Living Adult Donors in the United States," published as a Special Article in the February 27, 2003 issue of the New England Journal of Medicine.
The article is the first to present comprehensive data on adult to adult living donor liver transplantation (LDLT) in this country, with responses from 84 of the 122 programs now doing LDLT.
Those 84 centers performed more than 90 percent of all cadaveric liver transplants (transplants that use organs harvested from someone who has died) in the U.S. in 1999 and 2000.
Columbia University Medical Center has one of the nation's most active and outstanding living donor liver transplant programs.
Among the significant findings:
- Increasing numbers of liver transplant centers are performing adult LDLT, and the number of cases is increasing, with a total of approximately 1,000 to date
- Only two donor deaths have been directly related to living donor liver transplant, demonstrating the overall safety of the procedure
- Most living donor liver transplants are performed in large, high-volume transplant centers, yet many of the transplant centers that responded had done fewer than 10 LDLTs.
The methods for evaluating potential liver donors varied widely from center to center, as did the makeup of caregiving teams. In addition, many centers did not have accurate information about risks associated with LDLT.
"This survey represents the first attempt to gauge national trends in living donor liver transplantation," Dr. Brown said.
"It also demonstrates the need for standard criteria for evaluating who is and is not a candidate for living donor liver transplantation."
CUMC is now involved in extensive studies of LDLT.
One is the multicenter A2ALL (Adult to Adult Living Donor Transplantation) study, funded by NIH, whose goal is to provide information about outcomes of LDLT.
This information will help physicians, patients, and potential donors make informed choices about LDLT.
Information from this study will also help in setting standards for evaluating candidates for LDLT.
"Due to the shortage of cadaveric organs and the chances of dying while waiting for a donor organ, living donation is here to stay," Dr. Brown says.
"The data we collected supports our experience that this is a safe operation and that it saves lives of people waiting for a donor organ.
"I am especially pleased that this data was published in the New England Journal of Medicine, which reaches a wide range of internists and specialists. Liver donors are regular people, cared for by regular doctors, and this data should be of importance and interest to every physician."
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