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September 10, 2025Annals of Surgery

Living Donor Liver Transplantation reduced Waitlist Mortality in Acute-on-chronic Liver Failure

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Retrospective analysis shows improved overall survival in living donor liver transplant for ACLF patients, suggesting better waitlist outcomes.

ITT-LDLT achieved 92.9% survival at 3 months compared to 67.1% for ITT-DDLT, highlighting its effectiveness.
Transplant rates were significantly higher in ITT-LDLT at 94.5% versus 53.8% in ITT-DDLT, indicating better accessibility.
ACLF grade 2 and 3 patients showed the most significant survival benefits with LDLT, suggesting targeted efficacy.
Waitlist futility was more common in ITT-DDLT, with death or delisting rates at 35.7%, underscoring the need for improved donor strategies.

Wong et al. (2025) studied this question.

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Retrospective analysis shows improved overall survival in living donor liver transplant for ACLF patients, suggesting better waitlist outcomes.