Simplifying living donor liver transplantation

Living donor liver transplantation is a complex surgical operation. Treatment policies and operative techniques evolved in the last two decades.Our center's experience in living donor liver transplantation was reviewed in conjunction with relevant publications in the literature.The surgical techniques and perioperative surgical therapeutics could be modified towards simplicity. Examples include regular inclusion of the middle hepatic vein without compromising the venous outflow of the donor's remnant left liver. This provides excellent venous outflow, which is crucial for a small-for-size graft. Immunosuppression and hepatitis B suppression are steroid free and hepatitis B immunoglobulin free respectively.The most practical way to achieve high graft and recipient survival rates with an acceptably low donor risk is through design of a protocol that simplifies the surgery and postoperative management.