الفهرس 
Aim of the studyOnly 14 pages are availabe for public view
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Abstract
living donor liver transplantation of adults was initiated after the development of the procedure for children and in response to the shortage of cadaveric organs. according to the functional anatomy, the liver is divided into left and right lobes. the two liver lobes are each divided into four segments with defined inflow of arterial and portal blood and defined bile duct drainage. differentiated liver surgery with its countless new developments during the past decades especially ldlt is firmly based on our knowledge of the functional anatomy of the liver. the success of ldlt in pediatric population prompted its extension to adult population. the left lateral segment (ii-iii) is the preferred liver graft for pediatric but adult to adult operation requires great hepatic mass (segments v- vi- vii- viii). the liver diseases for which liver transplantation has been performed in adults can be divided into three broad categories; advanced chronic liver disease, fulminant hepatic failure and hepatic malignancy, also liver transplantation may be indicted in inherited metabolic liver diseases. the commonest indications of liver transplantation in infants and children are extrahepatic biliary atresia, metabolic disorders and primary hepatic malignancy. candidates for liver transplantation must be subjected to strict medical care preoperatively to put the patient in the best possible condition to obtain good result of the procedure. living donor liver transplantation requires both preoperative ct measurement of the segmental liver volume in donors and prediction of the standard liver volume, which fits the recipient’s metabolic demands. operative ultrasound to demonstrate the intrahepatic vascular structures as well as operative cholangiography to confirm the site of the bile duct division are essential. during graft transplantation in the recipient, reconstruction of arterial supply, portal supply, venous drainage as well as biliary drainage is done with different modalities. ldlt is a risky procedure for both donor and recipient and carries a lot of complications both intraoperative and postoperative. the risk for the donor is that of partial hepatectomy including intra and postoperative hemorrhage, biliary leakage and fistula and hepatic insufficiency. the most ominous risk to the recipient is that of primary graft non-function, with the addition of risks of bleeding and other biliary complications. that’s why ldlt must be carried out by the hands of expert surgeons to minimize morbidity and mortality for both donor and recipient. biliary complication is achills heel of liver transplantation. bile duct obstruction and leak are approximately one half of all technical complications after transplantation, and require reoperation in 10%-20% of patients. vascular complications remain an important cause of graft loss like hepatic artery thrombosis and stenosis, portal veins thrombosis and stenosis. abdominal wall complications like abdominal wall disfigurement, hernia, loss of function and prolonged recovery have been identified. so, minimally invasive techniques such as laparoscopic and hand assisted laparoscopic surgery have evolved over the past two decades. donors are completely healthy individuals performing at a high level of function and not in need for surgery. so, safety of donor and quality of life after donation must be considered. liver transplantation is an important move forward in the treatment of severe liver disease. it has opened a new world for patients who otherwise were destined to die from their liver disease. the operation is a major one, and there are still problems associated with it. but overall, patients can usually expect a good outcome with return to normal activities.