Introduction : Living donor liver transplantation (LDLT) has been widely used in Eastern Asia because of the limitation of potential living donors. Usually, living donors are offspring of patients. However, we cannot find the suitable living donors because of high fatty change and social problems. The aim of our study is to compare the outcomes between the spouse group and the offspring group after LDLT.

Methods : We retrospectively analyzed 1247 cases of primary liver transplantation in our center, between January 2009 and December 2018. Of these, deceased donor liver transplantation (DDLT), pediatric cases, re- or re-retransplantations and a case of LDLT from the siblings to nephew, were excluded. The recipient survival, graft rejection, bile duct complication and the association with various clinical factors were investigated.

Results : The spouse group (n=123) and offspring group (n=533) were identified in present study. There were statistically significant difference in donor sex and age (p<0.001), recipient age (p<0.001), and ABO-incompatible LDLT (p<0.001) between the two groups. However there were no significant difference in patient survival (p=0.268), acute rejection (0.473), and biliary complications (p=0.072) between the groups.

Conclusions : Highly selective spouse living donor donor should be considered as alternative living liver donor in LDLT.