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Abstract
Transplantation is one of the greatest achievement of modern medicine. With the integration of advances in: immunosupression and surgical techniques, understanding of liver pathophysiology and coagulation, and critical care of hepatic patients all make LT a widely accepted therapy for patients with end stage liver disease.
The first successful human orthotopic LT was performed in 1963 by starzl and his associates, progress was initially slow associated with poor survival. Over the next 10 year the number of recipients and survival rates have increased dramatically, and the procedure has become manageable. The persistent organ shortage and the numerous deaths of patients on waiting list were the driving force for the introduction of LDLT. LDLT for adult recipients is now a clinical reality, and the number of cases as well as the number of centers has dramatically increased over last 2 year initially only left lobes were taken from donors for transplantation. Because the left lobes are often marginally sized graft for adult recipients, Surgeons have moved more and more toward using the right lobe.
With LDLT there is reduction in the waiting time thus more patient could undergo transplantation before they die, also it is an elective procedure allowing for medical stabilization of the recipients with decompensated disease, the graft is obtained from a healthy person without any hepatic pathology, and reduction of cold ischemia time. It increases. LDLT associated with some potential disadvantages the most of which is the risk of complications in donor as well as the recipient has more biliary complications than the recipient of cadaveric organs.