Death of a living liver donor: Opening Pandora's box

Reddy, Mettu Srinivas; Narasimhan, Gomathy; Cherian, P. Thomas; Rela, Mohamed

doi:10.1002/lt.23731

Cited by 18 publications

(11 citation statements)

References 14 publications

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“…Published outcomes of living liver donors from the Indian subcontinent are scarce and are limited to three publications, one of which reported on a single-donor mortality. 1 We undertook a retrospective study of our living donor liver transplantation (LDLT) donors with specific regard to long-term outcomes and health-related quality of life (HRQOL) covering a 4-year period and herein report the results. found.…”

Section: Introductionmentioning

confidence: 99%

Long‐term health‐related quality of life in living liver donors: A south Asian experience

Cherian

Mishra

Mahmood

et al. 2017

Clinical Transplantation

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Section: Introductionmentioning

confidence: 99%

Long‐term health‐related quality of life in living liver donors: A south Asian experience

Cherian

Mishra

Mahmood

et al. 2017

Clinical Transplantation

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“…As described, the technique of IOC and its proper interpretation is very important. Application of a bulldog clamp to lower end of CBD ensures complete filling of the biliary system with minimal use of dye preventing complications such as dye‐related pancreatitis . Tethering can be caused by the caudate ducts at their site of insertion into the biliary ductal system, leading to overlapping and crowding of the bile ducts.…”

Section: Discussionmentioning

confidence: 99%

Analysis of caudate lobe biliary anatomy and its implications in living donor liver transplantation - a single centre prospective study

et al. 2018

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Biliary complications are a significant cause of morbidity after living donor liver transplant (LDLT). Bile leak may occur from bile duct (anastomotic site in recipient and repaired bile duct stump in donor), cystic duct stump, cut surface pedicles or from divided caudate ducts. The first three sites are amenable to post-operative endoscopic stenting as they are in continuation with biliary ductal system. However, leaks from divided isolated caudate ducts can be stubborn. To minimize caudate duct bile leaks, it is important to understand the anatomy of hilum with attention to the caudate lobe biliary drainage. This single-centre prospective study of 500 consecutive LDLTs between December 2011 and December 2016 aims to define the biliary anatomy of the caudate lobe in liver donors based on intraoperative cholangiograms (IOCs) with special attention to crossover caudate ducts and to study their implications in LDLT. Caudate ducts were identified in 468 of the 500 IOCs. Incidence of left-to-right crossover drainage was 61.37% and right to left was 21.45%. Incidence of bile leak in donors was 0.8% and in recipients was 2.2%. Proper intraoperative identification and closure of divided isolated caudate ducts can prevent bile leak in donors as well as recipients.

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“…Recently, Reddy and associates 36 from India reported a postoperative death of 29-year-old woman donor due to possible severe PAP. In that case, acute pancreatitis had not been considered among the differential diagnoses, and the patient, who had continued deterioration, had undergone relaparotomy with differential diagnosis of bowel perforation or ischemia.…”

Section: Adil Baskiran Et Al/experimental and Clinical Transplantatiomentioning

confidence: 99%

Acute Pancreatitis: A Rare but Serious Complication for Living Liver Donors; Risk Factors and Outcomes

Başkıran

Kement²,

Barut³

et al. 2022

Exp Clin Transplant

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Objectives: The purposes of this study were to determine the incidence of acute pancreatitis after living donor hepatectomy and to investigate potential risk factors and outcomes. Materials and Methods: Clinical data of all donors who underwent donor hepatectomy between January 2015 and December 2016 in our liver transplant institute were reviewed. Donor data were obtained from a prospectively maintained database. The donors were divided into 2 groups according to whether they developed postoperative pancreatitis. The following data were compared between the 2 groups: demographic information (age, sex), body mass index, type of hepatectomy (right, left, or left lateral), intraoperative cholangiographic findings, operative time, blood loss, graft data (graft weight, remnant liver ratio), duration of postoperative hospital stay, and postoperative morbidity and mortality (if any). Pancreatitis severity and treatment outcomes were also examined in patients with postoperative pancreatitis. Results: Our study included 348 donors who underwent donor hepatectomy for living-donor liver transplant. Postoperative pancreatitis developed in 6 donors (1.7%). We found no statistical differences between patients with and without postoperative pancreatitis in terms of demographic and intraoperative findings. Neither loco-regional nor systemic complications of pancreatitis developed in any of the patients. Therefore, all were classified as having mild pancreatitis according to revised Atlanta classification. The mean APACHE II score was 5.2 ± 1.2 points (range, 4-7 points). All patients with postoperative pancreatitis received conservative-supportive treatment. Conclusions:Although postoperative pancreatitis is a rarely reported complication in living liver donors, it should always be considered, especially in patients who unpredictably deteriorate in the postoperative period. Proper recognition and timely treatment can help avoid serious consequences. Key words: Hepatectomy, Liver transplantation, Postoperative complications IntroductionThe number of liver transplants has gradually increased, while the shortage of deceased donor organs continues to be a worldwide problem. In the United States, more than 16 000 patients are currently on wait lists for livers according to the Organ Procurement and Transplantation Network. More than 2000 candidates from this list die every year, although over 7000 liver transplants are performed annually in the United States. 1 Living-donor liver transplant (LDLT) is the main alternative solution to reduce the shortage of organs.The first LDLT was performed in Brazil in 1988, and the first successful case was reported in Australia. 2,3 The first adult-to-adult living donor liver transplant (A2ALL) was performed in Hong Kong in 1993. 4 Today, LDLT accounts for approximately 5% of liver transplants performed in the United States. 1 In some countries, like ours, this rate reaches over 80%.Beyond reducing the number of patients on wait lists, LDLT has some potential advantages, including detail...

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Death of a living liver donor: Opening Pandora's box

Cited by 18 publications

References 14 publications

Long‐term health‐related quality of life in living liver donors: A south Asian experience

Long‐term health‐related quality of life in living liver donors: A south Asian experience

Analysis of caudate lobe biliary anatomy and its implications in living donor liver transplantation - a single centre prospective study

Acute Pancreatitis: A Rare but Serious Complication for Living Liver Donors; Risk Factors and Outcomes

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