Living donor outcomes in an emerging living donor liver transplantation program: A single-center experience from Malaysia.

BACKGROUND: Living donor liver transplantation (LDLT) has become an essential strategy to address the shortage of deceased donor organs in Malaysia. Universiti Malaya Medical Centre (UMMC), the second public institution in the country to establish a liver transplantation program, initiated its adult LDLT program in 2017 and became the first center in the country to successfully perform a living-related adult right lobe LDLT. However, data on donor outcomes from emerging LDLT programs remain limited. AIM: To evaluate donor outcomes and perioperative results of an emerging LDLT program in Malaysia. METHODS: This retrospective cohort study included all living donor hepatectomies performed at UMMC from January 2017 to June 2025. Data on donor selection, perioperative management, morbidity, and mortality were analyzed. RESULTS: A total of 30 living donor hepatectomies were performed using right lobe, left lobe, and left lateral segment grafts. No donor mortality was observed. Complications included superficial wound infection (n = 4, 13.3%), anesthetic complications (n = 2, 6.7%), pulmonary atelectasis (n = 2, 6.7%), bile leak (n = 1, 3.3%), and gastrointestinal bleeding (n = 1, 3.3%). The median intraoperative blood loss was 500 mL (interquartile range: 400-800 mL), with a transfusion rate of 6.7%. The median length of hospital stay was 10 days. All donors achieved full functional recovery during follow-up. CONCLUSION: As an emerging liver transplantation program, UMMC demonstrated favorable donor safety outcomes consistent with published reports from established LDLT centers. Continued refinement of surgical techniques, multidisciplinary perioperative care, and public awareness initiatives will be essential for the sustainable expansion of liver transplantation in Malaysia.