Citations 2
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).
Post Living Donor Liver Transplantation Small-for-size Syndrome: Definitions, Timelines, Biochemical, and Clinical Factors for Diagnosis: Guidelines From the ILTS-iLDLT-LTSI Consensus Conference
Kow, Alfred Wei Chieh , Martin, Eléonora De , Soejima, Yuji , Watt, Kymberly D. , Xia, Qiang , Saraf, Neeraj, Kamel, Refaat, Srinvasan, Parthi, Elsabbagh, Ahmed M. , Pamecha, Vinayendra, Palaniappan, Kumar , Mas, Valeria R. , Tokat, Yaman , Asthana, Sonal , Cherukuru, Ramkiran , Egawa, Hiroto , Lerut, Jan , Bröering, Dieter C. , Berenguer, Marina , Cattral, Mark S. , Clavien, Pierre‐Alain , Chen, Chao‐Long , Shah, Samir , Zhu, Zhi‐Jun , Emond, Jean C. , Ascher, Nancy L. , Rela, Mohamed , Kim, Dong‐Sik , Ikegami, Toru , Group, On behalf of the ILTS-iLDLT-LTSI SFSS Working, Watt, Kymberly, Berenguer, Marina , Liu, Jiang , Patel, Madhukar S. , Reddy, Mettu Srinivas , Syn, Nicholas L. X. , Nasralla, David , McKenna, Greg J. , Palaniappan, Kumar , Asthana, Sonal , Rammohan, Ashwin , Bhangui, Prashant , Group, On behalf of the ILTS-iLDLT-LTSI SFSS Working
Transplantation | September 26, 2023 | Volume: 107 | Issue: 10 | Pages: 2226-2237
Background. When a partial liver graft is unable to meet the demands of the recipient, a clinical phenomenon, small-for-size syndrome (SFSS), may ensue. Clear definition, diagnosis, and management are needed to optimize transplant outcomes. Methods. A Consensus Scientific committee (106 members from 21 countries) performed an extensive literature review on specific aspects of SFSS, recommendations underwent blinded review by an independent panel, and discussion/voting on the recommendations occurred at the Consensus Conference. Results. The ideal graft-to-recipient weight ratio of ≥0.8% (or graft volume standard liver volume ratio of ≥40%) is recommended. It is also recommended to measure portal pressure or portal blood flow during living donor liver transplantation and maintain a postreperfusion portal pressure of <15 mm Hg and/or portal blood flow of <250 mL/min/100 g graft weight to optimize outcomes. The typical time point to diagnose SFSS is the postoperative day 7 to facilitate treatment and intervention. An objective 3-grade stratification of severity for protocolized management of SFSS is proposed. Conclusions. The proposed grading system based on clinical and biochemical factors will help clinicians in the early identification of patients at risk of developing SFSS and institute timely therapeutic measures. The validity of this newly created grading system should be evaluated in future prospective studies.