Assessing the attitudes of next of kin toward living donor liver transplantation for patients with colorectal liver metastases

Background:Colorectal cancer (CRC) is a leading cause of cancer mortality in Norway, with liver metastases being the most frequent manifestation. Liver transplantation (LT) has shown promise as a treatment for colorectal liver metastases (CRLM), with recent studies reporting improved 5-year overall survival (OS) rates ranging from 60% to 83%. However, the scarcity of available donor organs poses a significant challenge. Living donor liver transplantation (LDLT) utilizing segments 2+3 grafts by the RAPID technique (Resection and Partial Liver Transplantation with Delayed Hepatectomy) has been explored as a potential solution. Methods:This study aimed to assess the attitudes and considerations of next of kin toward living liver donation for patients with CRC. A survey was administered to three cohorts: next of kin to patients who underwent LT for CRLM, next of kin to patients with metastatic CRC ineligible for LT or liver resection, and healthcare workers with a healthy next of kin. The results showed that all respondents were willing to donate a portion of their liver if it could extend the recipient’s survival. Results:A significant majority (78%) expressed willingness to donate if it could extend survival by 6 months to 1 year. Children, siblings, or parents were more likely to find a survival benefit of 1 year or less acceptable compared to spouses or partners. The findings suggest that securing living familial donors for CRLM patients in Norway is feasible.