Soejima Y (2006) Feasibility of left lobe living donor liver transplantation between adults: an 8-year, single-center experience of 107 cases. Am J Transplant 6: 1004–1011

Although adult-to-adult living donor liver transplantation (LDLT) initially used the left liver lobe to minimize the risk of surgery for the donor, left-lobe LDLT has been all but abandoned because of the limited graft volume available to the recipient. As a consequence, the larger right lobe is now routinely used for adult-to-adult LDLT; however, the operative mortality rate for right-lobe donors has been reported to be as high as 0.5–1.0%. Limited data are available to compare left-lobe and right-lobe LDLT, because there is scant information available on the results of left-lobe LDLTs.

Soejima and colleagues have recently compared adult-to-adult left-lobe LDLT (107 procedures) with right-lobe LDLT (50 procedures), by evaluating the 8-year experience of a single center in Japan. The overall transplant-recipient survival rates, and cumulative graft survival rates, were found to be similar for right-lobe and left-lobe LDLTs, despite the mean graft volume being markedly smaller from left-lobe donors.

For left-lobe donors, the duration of hospitalization was shorter and post-transplant liver function was better than for right-lobe donors; however, morbidity rates were comparable for the two donor types.

The authors conclude that adult-to-adult left-lobe LDLT is a feasible option and should be more widely used to minimize donor morbidity and mortality rates.