Camino Valentin-Gamazo, Georgios C. Sotiropoulos, Silvio Nadalin, Massimo Malago, Christoph E. Broelsch. General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany

　　Living donor liver transplantation (LDLT) has developed as an effective therapy for selected patients with end stage liver disease. In Germany at present, due to the shortage of cadaveric organ livers, time on the waiting list for liver transplantation is longer than 18 months and mortality on the waiting list is increasing every year. In the present study, we evaluate the outcome of all patients considered for LDLT at our institution.
　　From April 1998 to November 2006 a total of 587 patients (68 children and 519 adults) were considered for LDLT at our institution. 189 (32%) patients were transplanted with suitable living donors. In 203 (35%) cases the evaluation of donors was not completed due to change in recipient status (cadaveric liver transplantation prior to LDLT, recipient death, recipient becoming too sick for LDLT or tumor progression). In 195 (33%) cases no suitable living donor was found. Out of them, 73 patients were transplanted with a cadaveric organ, 23 died on the waiting list before transplantation, 20 patients are still on the waiting list, 30 patients were dropped out of the list because of tumor progression and 49 patients could not be listed (24 because of tumor stage, 25 foreigners).
　　Only a minority of patients considered for orthotopic liver transplantation will lead to LDLT. The availability of suitable living donors may limit the application of LDLT. Further understanding of the cultural differences, as well as motivating factors, for why people volunteer for evaluation, may help to improve cadaveric and living donor transplant rates.