Is left lobe LDLT adequate for patients with a unsuitable right lobe donor

Abstract

Introduction: Left lobe is not a routinely used graft in adult living donor liver transplants, due to the smaller size. This causes a certain shortage of the available grafts , and also rejection of the donor , in whom the right lobe graft, is not feasible. A left lobe graft is a possible alternative in such patients. The aim of this study is to evaluate the possibility of a left lobe graft in adult LDLTs. Method: we have analysed retrospectively of the all the LDLTs at our centre from January 2014 to January 2018, a comparison was made between the right and left lobe transplant patients. The left lobe transplants were offered to recipients , for whom the RL donation was not feasible. Outcomes of the donors were also analysed. The statistical analysis was done using unpaired t-test for continuous variables and Chi square test for nominal variables. Result: The left lobe graft was most commonly used in the small right lobe donors .LL grafts had a shorter cold ischemia time(69.54±32.44mins vs 107.35±45.02mins,p=<0.0001), shorter surgery times for the donor and the recipients , SFSS (10.2% vs 6.6% ,p=0.38) and. The donor hospital stay was significantly less in LL (10.05±1.07 days 10.42±2.0,p value <0.04). 1 year survival and the other post operative parameters of the LL comparable to the RL. Conclusion: The left lobe LDLT is a viable alternative in donors whose right lobe donation is not feasible. We found the morbidity and mortality of the LL are similar to that of the right lobe , and the chances of the SFSS , is statistically comparable . It is superior in donor safety and comparable with the RL in recipient outcomes.