Acute liver failure (ALF), or fulminant hepatic failure, affects approximately two to three thousand patients (adults and children) annually in the United States and accounts for approximately eight percent of all liver transplants. Liver transplant for ALF is complicated by the fact that many patients who present with ALF spontaneously recover; however, the severe time constraints that ALF poses means that patients with ALF are usually listed for deceased donor liver transplant, and potential living donors begin donor evaluations even before it is known whether a transplant will be necessary. ALF was initially a contraindication to living donor liver transplantation (LDLT) both because of poor outcomes and because of concerns that the living donors did not have adequate time to give an informed and voluntary consent. Results have improved and ALF in now an accepted indication for LDLT. This chapter examines the ethical issues raised by LDLT in the setting of ALF.
Report of Donors of Living Donor Liver Transplantation at Dr. Cipto Mangunkusumo Hospital Jakarta: an Emerging Liver Transplant Center