Morbidity in Live Liver Donors

Abstract

The true extent of morbidity among live liver donors remains poorly understood. In this unique and often high-profile area of surgery, the development of standards for defining and reporting complications would foster a better understanding of the incidence and magnitude of such adverse events (AEs). Design: Retrospective review of AEs among live liver donors. Setting: University-affiliated teaching hospital. Patients and Methods: Of 202 individuals undergoing evaluation for live liver donation, 42 (20.8%) proceeded to surgery. Thirty-four underwent a right lobectomy without the middle hepatic vein; 3, a left lateral segmentectomy. Any event causing a deviation from a patient's ideal course was considered an AE and subsequently classified according to a derived framework. Morbidity was defined as 1 or more AEs. Main Outcome Measures: Incidence, timing, type, severity, and impact of AEs. Results: No deaths or significant hepatic dysfunction occurred. In 5 (12%) of the 42 donors, the hepatectomy was aborted for anatomic reasons before parenchymal transection. Eight (22%) of the remaining 37 experienced 11 AEs, of which 10 completely resolved, whereas 1 AE (3%) resulted in a permanent disability (brachial plexopathy). The overall incidence of AEs was 0.30 per case. Ten (91%) of the 11 AEs presented within the first postoperative month. Conclusions: Most live liver donations are uncomplicated or do not lead to permanent consequence. The adoption of a standards-based classification framework for AEs in live liver donors would allow for an inclusive, consistent, and universally applicable method to collect, analyze, and report donor morbidity.

Aborted donor hepatectomy in living donor liver transplantation: lessons learned

“…According to our literature review, prevalence of ADH ranged from 0.4-18.2%. [5][6][7]9,[17][18][19][20]26 The prevalence of ADH in our institute was 3.79%, which is consistent with the literature. Furthermore, 68.8% of the ADHs in our institute were due to donor related reasons and 31.2% of the ADHs were due to recipient related reasons.…”

“…The literature review analysis of the 25 published articles retrieved and the current series are summarised in Table 1 and Table 2. [5][6][7][8]10,11,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] Detailed information was obtained on 99 patients, 73 (73.3%) ADHs were due to donor reasons while 26 (26.7%) were due to reasons related to the recipient.…”