What are the differences between cadaveric liver transplantation and living donor liver transplantation?

Generally, there are differences between deceased donor liver transplantation and living donor liver transplantation in terms of procurement methods, survival duration, ischemic time, indications, surgical approaches, and preparation. The specific analyses are as follows:

1. Different Procurement Methods

Deceased donor livers are obtained from patients who have recently passed away or from brain-dead donors. Living donor livers are obtained from healthy donors, usually using a portion of the liver from a related donor for transplantation.

2. Different Survival Durations

Due to the preservation and transportation process after donation, the function of deceased donor livers may be somewhat affected, resulting in generally shorter survival times, typically around one month. In contrast, living donor livers usually have more stable function due to the close physiological relationship between donor and recipient, resulting in longer survival times, typically around three months.

3. Differences in Ischemic Time

Deceased donor livers experience longer ischemic times due to the time interval between donation and transplantation. Living donor livers have shorter ischemic times because the surgery can be performed promptly, significantly reducing biliary complications caused by ischemia-reperfusion injury.

4. Different Indications

Deceased donor liver transplantation is mainly indicated for patients with severe liver damage or liver failure. Living donor liver transplantation is suitable for patients with relatively preserved liver function, such as those with congenital metabolic disorders or hepatic tumors. Patients with severe liver failure are not recommended for living donor liver transplantation.

5. Different Surgical Approaches and Preparation

The surgical approach for deceased donor liver transplantation is relatively fixed, and preoperative preparation may be more urgent. Living donor liver transplantation offers a more flexible surgical approach. As it is an elective procedure, preoperative imaging of the donor's and recipient's intra- and extra-hepatic vasculature and bile ducts can be fully evaluated, the recipient's nutritional status optimized, and vital organ functions improved. Comprehensive preoperative discussions allow formulation of detailed treatment plans.

To enhance treatment effectiveness when managing diseases, patients should maintain good lifestyle habits and follow healthy, scientific dietary practices to actively improve their physical condition.