Citations 3
Living liver donor safety: Intraoperative considerations in living liver donation—Guidelines from the ILTS–iLDLT group consensus conference 2025
Bhangui, Prashant , Hakeem, Abdul Rahman , Maira, Tommaso Di , Rammohan, Ashwin, Sayed, Blayne A. , Soejima, Yuji , Shingina, Alexandra , Cheah, Yee Lee , McCluskey, Stuart, Spiro, Michael , Ganesh, Swaytha , Rajalingam, Rajesh , Gupta, Subash , Findlay, James Y. , Chieh, Alfred Kow Wei, Sakamoto, Seisuko, Xia, Qiang, Kim, Ki-Hun , Polak, W., Soin, A G, Pomposelli, James J. , Vyas, Mary, Wiggins, Chantal, Mas, Valeria, Taner, Timucin, Broering, Dieter, Chen, Chao-Leng, Burra, Patrizia, Ascher, N. L., Lerut, Jan, Rela, Mohamed, Selzner, Nazia, Balci, Deniz, Olthoff, Kim M. , Polak, Wojciech G. , Hakeem, Abdul , Rammohan, Ashwin , Sayed, Blayne A , McCluskey, Stuart , Findlay, James, Sakamoto, Seisuko , Xia, Qiang , Polak, Wojciech G , Sapisochin, Gonzalo , Pomposelli, James , Selzner, Nazia , Balci, Deniz , Bhangui, Prashant , Di Maira, Tommaso , Gupta, Amar C. , Xia, Qiang , Sapisochín, Gonzalo , Soin, Arvinder S., Taner, Timuçin , Bröering, Dieter C. , Terrault, Norah A. , Burra, Patrizia , Hirschfield, Gideon M. , Lerut, Jan , Rela, Mohamed , Heimbach, Julie K. , Selzner, Nazia
Liver Transplantation | January 5, 2026 | Volume: 32 | Issue: 4 | Pages: 592-608
The success of living donor liver transplantation (LDLT) has bridged the growing gap between organ demand and availability in patients with liver failure or liver cancer. Safety of the living liver donor (LLD) is paramount, and astute intraoperative management plays a critical role in ensuring optimal outcomes for them. Given that intraoperative surgical and anesthesia practices vary widely across centers, the International Liver Transplantation Society (ILTS) and the International Living Donor Liver Transplantation Group (iLDLT Group) convened a global consensus conference in Toronto in March 2025 to develop guidelines for intraoperative management of the LLD. This manuscript details the recommendations on intraoperative considerations for the safety of LLD developed by Working Group II of the Consensus Scientific Committee, using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system for assessment of recommendations, and the Danish model of consensus. Working Group II focused on intraoperative monitoring, fluid and ventilation strategies, surgical techniques for vascular and biliary division, surgeon and center-specific experience, and intraoperative crises planning. These guidelines aim to support both established and emerging LDLT teams to ensure high-quality and safe intraoperative care for the LLD.
Living liver donor safety: Early postoperative considerations of living liver donation guidelines from the ILTS-iLDLTG consensus conference
Sayed, Blayne Amir, Tejedor, Marta , Kathirvel, Manikandan , Bhangui, Prashant , Ghanekar, Anand, Kasahara, Mureo , Scatton, Olivier, Ghobrial, Mark, Klair, Tarunjeet , Rajakumar, Akila , Bezinover, Dimitri , Bittermann, Therese , Don, C, Luzzi, Carla , Tsien, Cynthia , Egawa, Hiroto , Ascher, Nancy L. , Bröering, Dieter C. , Chen, Chao‐Long , Lerut, Jan , Mas, Valeria R. , Taner, Timuçin , Vyas, Mary, Wiggins, Chantal, Olthoff, Kim M. , Rela, M, Selzner, Nazia, Sayed, Blayne A. , Bhangui, Prashant , Rammohan, Ashwin , Selzner, Nazia , Tejedor, Marta , Sayed, Blayne A , Chadha, Ryan , Ivanics, Tommy , Kim, Dong‐Sik , Scatton, Olivier , Ghobrial, Mark, Sudhindran, S , Benedetto, Fabrizio Di , Burra, Patrizia , Hirschfield, Gideon M. , Terrault, Norah A. , Wiggins, Chantal, Fung, John J. , Heimbach, Julie K. , Selzner, Nazia
Liver Transplantation | December 18, 2025 | Volume: 32 | Issue: 6 | Pages: 913-924
Living donor liver transplantation (LDLT) is a life-saving procedure for patients with end-stage liver disease. As its use expands worldwide, ensuring the safety and well-being of live liver donors (LLD) is of paramount importance. Published evidence on early postoperative complications after living donor hepatectomy—those occurring within 90 days of surgery—is limited, and standardized postoperative care protocols are lacking. The International Liver Transplantation Society (ILTS) and the International Living Donor Liver Transplantation Group (iLDLT Group) convened a consensus conference in Toronto in March 2025 to develop guidelines for the safe care of the LLDs. This manuscript details the recommendations on early postoperative considerations for the safety of LLDs developed by Working Group III (WGIII) of the Consensus Scientific Committee, using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system for assessment of recommendations, and the Danish model of consensus. WGIII addressed four key areas: (1) standardized postoperative care, (2) early biliary complications, (3) early postoperative liver dysfunction, and (4) early postdischarge follow-up. This report emphasizes the need for vigilant postoperative monitoring in specialized units, with access to experienced providers and defined clinical pathways. Structured clinical and psychosocial follow-up protocols, perioperative prophylaxis for surgical site infections and venous thromboembolism, and management of early biliary and vascular complications are discussed. These may help standardize care, reduce complications and improve short-term outcomes in LLDs.
Variations in liver allocation systems across continents with a focus on MELD exceptions
Tanaka, Tomohiro , Polak, Wojciech G. , Vinaixa, Carmen , Russo, Francesco Paolo, Kabaçam, Gökhan , Chaudhury, Prosanto , Pillai, Anjana , Selzner, Nazia, Russo, Francesco Paolo , Polak, Wojciech G , Kabacam, Gökhan , Heimbach, Julie K , Hakeem, Abdul , Chadha, Ryan , Francoz, Claire , Russo, Francesco Paolo , Line, Pål‐Dag , Liu, Ken , Contreras, Alan G. , Selzner, Nazia , Heimbach, Julie K.
Liver Transplantation | October 16, 2025 | Volume: 32 | Issue: 5 | Pages: 748-764
Variations in liver allocation systems worldwide are presented, with a specific focus on regional differences and their potential impact on outcomes, with the goal of serving as a reference for future policy development. Summaries of liver allocation across multiple European, Scandinavian, and Asian systems, as well as the combined allocation system of Australia plus Canada, the United States, and the systems in Central America, South America, and the Caribbean are reviewed. A comprehensive comparison of how different regions address MELD exceptions, primarily focusing on hepatocellular carcinoma, along with the most common etiologies of liver disease requiring transplantation is presented. In addition, the adoption of living donation and donation after circulatory death is discussed. The study involves contributions from a diverse group of world experts in liver transplantation and may serve as an essential resource to foster international dialogue as countries strive to optimize organ allocation policies, including MELD exceptions.