As compared to deceased donor liver transplantation (DDLT), living donor liver transplantation (LDLT) offers the potential advantage of an expedited operation. Patients with an urgent need for transplant, including those with hepatocellular carcinoma (HCC), may benefit from the shorter pretransplant waiting time afforded by LDLT. Since one of the most effective therapies for HCC patients is transplantation, prolonged pretransplant waiting times increase the risk of HCC progression thereby jeopardizing the chance of transplant and increasing the risk of post-transplant recurrence. In fact, approximately 15-20% of HCC patients are removed from the list due to disease progression while awaiting a transplant (1,2). Therefore, rapid procession to transplantation potentially offers a clear therapeutic advantage in the treatment of HCC, However, problems with this strategy have become apparent.
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