Donor Morbidity After Living Donation for Liver Transplantation

Abstract

Background & Aims-Reports of complications among adult right hepatic lobe donors have been limited to single centers. The rate and severity of complications in living donors were investigated in the 9-center Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL).

Use of a Right Lateral Sector Graft in Living Donor Liver Transplantation Is Feasible, but Special Caution Is Needed With Respect to Liver Anatomy

“…This complication rate is similar to that reported in association with RLG procurement (24)(25)(26)(27).…”

“…RLG procurement has been considered to be associated with a higher rate of severe According to the classification of Dindo et al (18). complications in the donor because of the resection of a larger liver volume than for the case of other types of graft (24)(25)(26)(27). In our case series, the postoperative liver enzymes were higher because of congestion in the right paramedian sector and/or longer hepatic inflow occlusion time, and the frequency of bile leakage was slightly higher in the RLS donors.…”

Revisiting the Safety of Living Liver Donors by Reassessing 441 Donor Hepatectomies: Is a Larger Hepatectomy Complication-Prone?

“…As shown in Figures 3 and 4, metabolic and productive burdens of remnant livers proved by blood tests after RH were large compared to those after LH or LLS, even though we set the limit on remnant liver volume at 35%. There have been devastating consequences after living liver donation around the world, most of which occurred after right hepatic donation (28)(29)(30)(31)(32). Enthusiasm for the use of extensive RH grafts has been recently dampened in many transplant centers since those devastating reports were published.…”

Overview of the Indications and Contraindications for Liver Transplantation

“…The remaining liver in the donor regenerates within 3 mo to 90% of its original volume. The donor has a risk of a 30% morbidity and a mortality risk of up to 0.8% (Ghobrial et al 2008). Especially, the bile duct system has to be evaluated intraoperatively by cholangiogram, and aberrant bile ducts have to be taken care of meticulously (Jeon et al 2013).…”