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  • 1 The Jikei University School of Medicine Department of Surgery Tower C, 4th Floor, 3-19-18 Nishi-shinbashi Minato-ku Tokyo 105-8471 Japan
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A total of 3,816 liver transplantations [3,783 live donor liver transplantation (LDLT), 33 deceased donor liver transplantations (DDLT)] have been performed in 55 transplant centers as of December 31, 2005 in Japan. The number of LDLT in each year has been increasing since 1989 and reached 562 in 2005. The cumulative 1-year, 3-year, 5-year, 10-year and 15-year patient survival after LDLT was 81.7%, 77.9%, 76.1%, 72.3%, and 72.3%, respectively. The cumulative 1-year, 3-year, 5-year, 10-year and 15-year graft survival after LDLT was 81.2%, 77.1%, 75.1%, 70.5%, and 69.8%, respectively. In January 2004, almost all indications for LDLT were covered by health insurance by the Japanese Government. LDLT in Japan will remain a major therapeutic option for end-stage liver disease although safety for live donors is a considerable concern. In technical aspects, tailoring the liver grafts is almost established and vascular complication has been reduced. However, late biliary complications still remain a problem. Some of the late recipient mortalities are due to recurrence of hepatitis C and hepatocellular carcinoma (HCC). In this article, we review the evolution of LDLT over the last couple of decades.

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