Abstract
Liver transplantation has evolved into the standard treatment for numerous endstage liver diseases. The increase of organ shortages led to living organ donation. In 1988 living donor liver transplantation (LDLT) was performed for the first time. Since then multiple difficulties associated with LDLT have been solved. In Kyoto we can look back on more than 900 transplantations since the initiation of our LDLT program in 1990, which is the oldest in Japan and the largest in the world. In the following we review our extensive experience with special focus on issues such as donor safety, results after LDLT, and potential complications in the recipient. Further, graft size mismatching, venous drainage from anterior segment of the right lobe graft, LDLT for hepatocellular carcinoma, AB0-incompatible transplantation, and recurrence of hepatitis C infection, which are still unsolved problems in LDLT, are described and future directions are indicated.
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