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World J Transplant. Sep 18, 2026; 16(3): 122256
Published online Sep 18, 2026. doi: 10.5500/wjt.122256
Published online Sep 18, 2026. doi: 10.5500/wjt.122256
Living donor outcomes in an emerging living donor liver transplantation program: A single-center experience from Malaysia
Yeong Sing Lee, Shi Yu Cheng, Arbaie Hannis, Peng Soon Koh, Hepatobiliary and Liver Transplantation Unit, Division of General Surgery, Department of Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 59100, Malaysia
Sanjiv Mahadeva, Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 59100, Malaysia
Kee Seang Chew, Paediatric Gastroenterology and Hepatology Unit, Department of Paediatrics, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 59100, Malaysia
Co-first authors: Yeong Sing Lee and Shi Yu Cheng.
Author contributions: Lee YS and Koh PS conceived and designed the study and developed the overall methodological and conceptual framework for evaluating living donor outcomes in an emerging living donor liver transplantation program; Lee YS and Hannis A were responsible for data curation, including the collection, verification, and organization of clinical and perioperative donor data; YS Lee and Cheng SY performed the formal data analysis, interpreted the findings, and contributed substantially to the statistical and clinical evaluation of donor outcomes as co-first authors; Lee YS, Cheng SY, Hannis A, Mahadeva S, Chew KS, and Koh PS participated in the investigation by contributing to donor evaluation, perioperative management, and program development, and by providing important intellectual input into the design, conduct, and interpretation of the study; Lee YS and Cheng SY drafted the original version of the manuscript; Koh PS provided overall supervision of the study, oversaw the liver transplantation program and its clinical governance, and guided the overall scientific direction and refinement of the manuscript; and all authors critically reviewed and revised the manuscript for important intellectual content and approved the final version for submission.
AI contribution statement: The authors take full responsibility and accountability for the content of this manuscript. ChatGPT (OpenAI) was used as an assistive tool for language editing, improving clarity, restructuring the manuscript, and refining the presentation of the text. All AI-assisted outputs were carefully reviewed, verified, and revised by the authors. AI tools were not used to generate original research data, perform statistical analyses, interpret study findings independently, or formulate the scientific conclusions.
Institutional review board statement: This study was approved by the Institutional Review Board of Universiti Malaya Medical Research.
Informed consent statement: This study did not involve prospective recruitment, interventional procedures, direct patient contact, or the collection of additional data from participants for research purposes. Accordingly, the requirement for informed consent for participation was waived owing to the retrospective, noninterventional nature of the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The technical appendix, statistical code, and dataset are not publicly available and are accessible only to the authors, as they contain confidential donor information and institutional identifiers. No additional data beyond those presented in the article are available.
Corresponding author: Peng Soon Koh, MBBS, MRCSEd, Associate Professor, Hepatobiliary and Liver Transplantation Unit, Division of General Surgery, Department of Surgery, Faculty of Medicine, Universiti Malaya, Lembah Pantai, Kuala Lumpur 59100, Malaysia.
Received: April 15, 2026
Revised: July 13, 2026
Accepted: August 10, 2026
Published online: September 18, 2026
Processing time: 137 Days and 8.7 Hours
Revised: July 13, 2026
Accepted: August 10, 2026
Published online: September 18, 2026
Processing time: 137 Days and 8.7 Hours
Core Tip
Core Tip: Universiti Malaya Medical Centre established Malaysia’s first structured adult living donor liver transplantation program in a public institution (2017) and has performed 30 living donor hepatectomies using right lobe, left lobe, and left lateral segment grafts. Donor safety is maintained through rigorous three-phase donor evaluation, multidisciplinary selection meetings, standardized open hepatectomy with routine intraoperative cholangiography, and protocol-driven perioperative care. Zero donor mortality, low-incident self-limiting complications, favorable intraoperative blood loss and length of hospital stay, and complete functional recovery indicate living donor liver transplantation can be safe in a low-volume, resource-constrained center when supported by robust clinical governance and evolving institutional expertise.