Eligibility and causes of disqualification among living liver donor candidates: A single-center analysis of 991 candidates
- Author:
Eun-Ju NAM
1
;
Jong-Hyun KIM
;
Hae-In SHIN
;
Young-In YOON
;
Deok-Bog MOON
;
Ki-Hun KIM
;
Tae-Yong HA
;
Gi-Won SONG
;
Dong-Hwan JUNG
;
Gil-Chun PARK
;
Shin HWANG
;
Sung-Gyu LEE
Author Information
- Publication Type:Original Article
- From: Annals of Liver Transplantation 2026;6(1):17-24
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:A systematic evaluation of potential living liver donors is essential to ensure donor safety and optimize recipient outcomes in living donor liver transplantation (LDLT). This study aimed to assess donor acceptance rates and reasons for disqualification among individuals evaluated for LDLT at a high-volume transplant center over a one-year period.
Methods:We retrospectively reviewed 1,087 potential living liver donors who presented for LDLT evaluation in 2023. Of these, 991 candidates advanced beyond the initial screening (Stage 1) and underwent comprehensive clinical, imaging, and pathological assessments (Stages 2 and 3). Candidates who discontinued after Stage 1 were excluded due to the absence of documented reasons for non-progression.
Results:Among the 991 candidates who proceeded beyond initial screening, 473 (47.7%) completed the full donor evaluation, of whom 466 were judged to be suitable donors. Among suitable donors, 384 (82.4%) proceeded to donor hepatectomy, whereas 82 did not, primarily due to recipient-related factors such as clinical deterioration or withdrawal of consent. Donor ineligibility was determined in 422 candidates (42.6%), most commonly due to inadequate remnant liver volume (52.8%), hepatic steatosis (20.6%), and insufficient graft size (10.2%). Among candidates undergoing Stage 2 evaluation, 162 (16.3%) failed to meet steatosis criteria; 126 were excluded solely for steatosis and advised weight reduction, and 39 subsequently became eligible and successfully donated.
Conclusion:In this high-volume LDLT center, donor disqualification was primarily driven by remnant liver volume and hepatic steatosis. Targeted interventions such as weight reduction enabled successful donation in a subset of initially ineligible candidates, underscoring the importance of individualized donor evaluation and pre-donation optimization.
