Liver transplant donation
Orthotopic liver transplantation provides definitive management of end-stage liver disease. While short and long-term outcomes for graft survival and patient survival are excellent, a limiting factor has been persistent mismatch of the number of available donors to the number of recipients in need of organs. Strategies to address these donor short falls include: utilization of living related donors, split liver transplantation, donation by cardiac death, hepatitis serology positive donors, and marginal liver donors. With careful recipient selection, the overall outcomes do not appear to differ between the use of standard neurologic death donors and these extended criteria donors. As indications for liver transplantation continue to expand, innovative strategies to increase the donor pool are necessary to mitigate patient mortality while on liver transplant wait lists and morbidity of end-stage liver disease.