Living Donor Liver Transplantation in Japan

Twenty years have passed since the first case of living donor liver transplantation (LDLT) in Japan. The recipients of LDLT have rapidly changed from children to adults through the use of right lobe grafts. The number of LDLTs in Japan has increased since January 2004 because of indication for LDLT changed widely in an insurance application. (UNCLEAR) A total of 4,292 LDLTs have been performed as of December 31, 2006, and 2,621 (61.1%) of these have been adult-to-adult LDLTs. Patients who have hepatocellular disease or hepatocellular carcinoma or both account for more than 50% of all recipients in Japan. The overall 3-, 5- and 10-year survival rates were 73.8%, 70.4%, and 66.3%, respectively. There were no significant differences in survival rates between LDLT in Japan and cadaveric transplantation in America or Europe. The survival rates will improve to clarify the timing and indications for LDLT and the optimal operative procedures. However, because of the number of patients requiring transplant will increase, it is important that cadaveric donor liver transplant is promoted in addition to LDLT in Japan.