Citations 4
Living liver donor safety: Preoperative aspects of living liver donation—Guidelines from the ILTS–iLDLT consensus conference
Patel, Madhukar , Magistri, P., Sayed, Blayne A. , Rammohan, Ashwin, Humar, Abhinav, Abbey, Susan , Badenoch, Heather, Bhangui, Pooja , Cattral, M C, Durand, F., Hibi, Taizo, Jhaveri, Kartik , Kabacam, Gokhan, Khan, Maaz , Malik, Ashish, Nadalin, S., Ng, Vicky L, Petrowsky, Henrik , Pillai, Anjana , TOKAT, YAMAN, Wong, Tiffany, Yilmaz, Sezai, Yoshizumi, T., Nl, Ascher, Broering, Dieter, Burra, Patrizia, Chen, Chao-Long, Lerut, J., Mas, Valeria R. , Taner, Timucin, Terrault, Norah, Vyas, Mary, Wiggins, Chantal, Heimbach, Julie, Ng, Vicky L. , Rela, M., Patel, Madhukar S. , Selzner, Nazia , Sayed, Blayne A , Rammohan, Ashwin , Humar, Abhinav , Abbey, Susan , Ng, Vicky L , Rela, Mohamed , Bhangui, Prashant , Selzner, Nazia , Khan, Mohammad Qasim , Magistri, Paolo , Humar, Abhinav , Cattral, Mark S. , Durand, François , Gross, Jed Adam , Hibi, Taizo , Kabaçam, Gökhan , Malik, Ashish , Nadalin, S., Reddy, Mettu Srinivas , Wong, Tiffany, Yilmaz, Sezai , Yoshizumi, Tomoharu , Bröering, Dieter C. , Burra, Patrizia , Hirschfield, Gideon M. , Taner, Timuçin , Terrault, Norah A. , Heimbach, Julie K. , Rela, Mohamed , Bhangui, Prashant
Liver Transplantation | January 9, 2026 | Volume: 32 | Issue: 7 | Pages: 1049-1065
Living donor liver transplantation (LDLT) is an established therapy with curative intent for pediatric and adult patients with acute liver failure and end-stage liver disease. Donor safety remains paramount and commences during preoperative evaluation and assessment. Given the importance of the topic, the International Liver Transplantation Society and International Living Donor Liver Transplantation Group consensus conference on Living Liver Donor Safety was convened in March 2025 (Toronto, Canada). Recommendations were based on the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system for assessment of recommendations, and the Danish model of consensus was followed. This report presents 28 recommendations from the working group focused on addressing clinically relevant questions related to the preoperative aspects of living donor safety including assessment of donor acceptability (age, body mass index and hepatic steatosis; medical conditions and contraindications), medical and surgical workup (liver function and procoagulant workup; anatomical considerations and safe remnant), and psychosocial evaluation (timing and team; underlying conditions; non-directed, paired, and anonymous directed donors; urgent living donor workups for acute liver failure).
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.
Long-term considerations following living liver donation—Guidelines from the 2025 ILTS-iLDLT consensus conference on living liver donor safety
Sayed, Blayne A. , Jung, Dong-Hwan, Watt, Kymberly D. , Maluf, Daniel G. , Zhu, Zhi‐Jun , Eghtesad, Bijan , Minnee, Robert C. , James, Paul M., Man, Nancy Kwan, Liapakis, AnnMarie , Fipps, David C. , Taner, Timuçin , Wiggins, Chantal, Ascher, Nancy L. , Mas, Valeria, Chen, Chao‐Long, Vyas, Mary, Suk-Suh, Kyung, Broering, Dieter , Lerut, Jan , Olthoff, Kim M. , Rela, Mohamed, Fipps, David C , Sayed, Blayne A , Chan, Albert C Y , Rammohan, Ashwin , Shankar, Sadhana , Syn, Nicholas L. X. , Mathew, Johns Shaji , Bhangui, Prashant , Jung, Dong‐Hwan , Pomfret, Elizabeth , Roberts, John P. , Selzner, Markus , Chan, Albert , Chaudhary, Abhideep , Eguchi, Susumu , James, Paul, Goldaracena, Nicolás , Kodali, Sudha , Kim, Jong Man , Wiggins, Chantal, Terrault, Norah A. , Burra, Patrizia , Hirschfield, Gideon M. , Heimbach, Julie K. , Selzner, Nazia , Rela, Mohamed
Liver Transplantation | December 18, 2025 | Volume: 32 | Issue: 8 | Pages: 1194-1209
Living liver donation is a critical component for addressing organ shortage and improving outcomes for patients with end-stage liver disease. As the prevalence of living donor liver transplantation (LDLT) increases worldwide, understanding and optimizing long-term donor health is paramount. The 2025 International Liver Transplantation Society and International Living Donor Liver Transplantation Society (ILTS-iLDLT) Consensus Conference convened experts in the field of liver transplantation to establish evidence-based guidelines focused on the long-term medical, psychological, and social considerations following living liver donation. The aim of this working group was to integrate current evidence and expert consensus on donor follow-up protocols, risk assessment, and management strategies to promote long-term donor health, quality of life, and living liver donor programs globally to safeguard the welfare of this unique population.