*Purpose: Donor safety is major concern during living donor liver transplantation (LDLT) and most transplant centers accept strict selection criteria although some centers have been trying to modify these strict criteria to expand donor pools. Herein, we describe out center’s experience for extended living donor criteria for LDLT focusing on donor safety.

*Methods: retrospectively reviewed the outcomes of 424 living donor right hepatectomy (LDRH) including 105 donors under extended criteria at our institution from January 2010 to June 2019. Extended Donor was defined with criteria as follows; 1) old donor (age >40 years) with remnant liver volume of <35%, 2) young donor (age ≤40 years) with remnant liver volume <29% and minimal fatty change (<15%), 3) young donor with mild hepatosteatosis (15%-30%) and remnant liver volume of < 35%. The outcomes in extended living donors were compared with those in living donors under conventional criteria focusing on donor safety. We also analyzed risk factors related to posthepatectomy liver failure (PHLF).

*Results: PHLF occurred in 43 donors (10.1%) and most cases were grade A except one case in conventional donor group (grade B) and PHLF did not occur more frequently in extended donor group. (7.6% vs. 11.0% % P = 0.32) and the incidence of major postoperative complications did not differ between the 2 groups. Moreover, no difference in either posttransplant graft function or survival was apparent between the 2 groups. In multivariate logistic regression analyses, only the event for major complications (OR, 3.002; 95% CI, 1.042-8,649; P = 0.042) was associated with PHLF but not related to our extended criteria.

*Conclusions: LDRH under our extended criteria could be performed to expand donor pools without adverse effects on donor safety.

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