Outcomes of Left-Lobe Donor Hepatectomy for Living-Donor Liver Transplantation: A Single-Center Experience

Usta, Sertaç; Ateş, Mustafa; Dirican, Abuzer; Işık, Burak; Yılmaz, Sezai

doi:10.1016/j.transproceed.2013.02.065

Cited by 12 publications

(8 citation statements)

References 15 publications

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“…The overall incidence of complications in our series was 22.3% (RL‐22.6%, LL‐22.2%, LLS‐16.3%, P = 0.99). However, the incidence of grade IIIa, IIIb, IV and V complications in our series (RL 4.2%, LL 2.7% and LLS 4.08%, P = 0.89) was comparable to other large series .…”

Section: Discussionsupporting

confidence: 79%

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Right lobe donor hepatectomy: is it safe? A retrospective study

et al. 2017

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Donor safety is utmost important in Living donor liver transplantation (LDLT). Small for size syndrome in some recipients with left lobe donors led to the evolution of right lobe LDLT. The aim of the study was to analyze the safety of large series of right lobe (RL) donor hepatectomies and compare outcomes with left lobe (LL) and left lateral segment (LLS) donations. A consecutive cohort of 726 donors from January 2011 to January 2014 were studied; RL (n = 641, 88.3%), LL (n = 36, 4.9%) or LLS (n = 49, 6.8%) depending on the type of donation. The mean age was 34.6 ± 10 years. The overall complication rate was 22.3%. Most were Clavien grade I and II. Clavien grade IIIa, IIIb, IV and V were noted in 4.2% donors. The incidence of these major complications were comparable among RL (n = 28, 4.2%), LL (n = 1, 2.7%) and LLS (n = 2, 4.08%) (P = 0.89). Bile leak was seen in 20 donors (2.7%) and 13 were managed conservatively with prolonged or additional intra-abdominal drainage. Seven underwent re-exploration for bile leak. In centres experienced in right lobe LDLT, morbidity after RL donation is similar to that of LL donation; and with adequate GRWR, same 1-year recipient outcomes.

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Section: Discussionsupporting

confidence: 79%

“…The most worrisome morbidity in a donor is liver failure [21,26,27]. In our study, we have not experienced any incidence of such complications.…”

Section: Discussionmentioning

confidence: 53%

Right lobe donor hepatectomy: is it safe? A retrospective study

et al. 2017

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“…3 Although adult-to-adult LDLT outcomes for postoperative complications are similar to donor transplant recipients, there are many concerns about donor morbidity reported. [1][2][3][4][5][6][7] Until now, many studies have been published, reporting median 16% adult donor morbidity after LDLT. 1 The reported severe postoperative complications are mostly abdominal, and pulmonary complications have a lower incidence.…”

Section: Introductionmentioning

confidence: 99%

Postoperative Pulmonary Complications in Living-Liver Donors: A Retrospective Analysis of 188 Patients

Ulubay

Dedekarginoglu²,

Küpeli̇³

et al. 2015

Exp Clin Transplant

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Objectives: Living-donor liver transplant has become a viable option and an important source of hepatic grafts. The goal of this study is to establish postoperative pulmonary complications of liver donation surgery in our center. Materials and Methods: Data from 188 subjects (median age, 33.7 ± 8.4 y; male/female, 51.1%/48.9%) who had liver donation surgery from 1988 to 2013 were analyzed retrospectively. Patient demographic and clinical features were recorded. Postoperative complications and the correlation of risk factors for postoperative pulmonary complications were investigated. Results: The incidence of early postoperative complications was 17% (n = 32), and 16 of these patients had postoperative pulmonary complications (8.5%); 2 of the postoperative pulmonary complications were detected on the day of surgery and the other 14 complications were observed between the second and seventh day after surgery. Most postoperative pulmonary complications were minor complications including atelectasis, pleural effusion, and pneumonia. There was 1 major postoperative pulmonary complication: pulmonary embolism that occurred on the fourth day after surgery in 1 patient. Late pulmonary complications also were reviewed and no late postoperative pulmonary complications were observed. There was no significant difference in early and late postoperative pulmonary complications between ex-smokers and smokers. Postoperative atelectasis was significantly higher in patients with body mass index ≤ 20 kg/m² than patients with body mass index > 21 kg/m² (P = .027). In our study population, no postoperative mortality was recorded. Conclusions: We believe that preoperative weight reduction strategies and early mobilization with postoperative respiratory physiotherapy could be important factors to reduce postoperative pulmonary complications in liver donors.

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“…The preferred technique for LDH has been described in previous studies from our institute [13–15]. The procedure starts with cholecystectomy, and we routinely perform intraoperative cholangiography.…”

Section: Methodsmentioning

confidence: 99%

Diagnostic and therapeutic management algorithm for biliary complications in living liver donors

et al. 2021

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Summary This study aimed to demonstrate the efficacy of our diagnostic and therapeutic management algorithm and catheter‐assisted (percutaneous transhepatic biliary tract drainage [PTBD] or transanastomotic feeding tube) hepaticojejunostomy (HJ) procedures in living liver donors (LLDs) with biliary complications. Living donor hepatectomy (LDH) was performed between September 2005 and April 2021 in 2 489 LLDs. Biliary complications developed in 220 LLDs (8.8%), 136 of which were male, and the median age was 29 (interquartile range [IQR]: 12) years. Endoscopic sphincterotomy ± stenting was performed in 132 LLDs, which was unsuccessful in 9 LLDs and required HJ. Overall, 142 LLDs underwent interventional radiologic procedures. Fifteen LLDs with biliary complications underwent HJ (PTBD catheter = 6 and transanastomotic feeding tube = 9) at a median of 44 days (IQR: 82). Following HJ, 14 LLDs did not have any complications throughout the median follow‐up period of 1619 days (IQR: 1454). However, percutaneous dilation for HJ anastomotic stricture was performed in one patient. Biliary complications are very common following LDH; therefore, surgeons in the field should have a low threshold to perform HJ for biliary complications that persist after other treatments. Our catheter‐assisted HJ techniques demonstrated a high success rate and aided HJ in a hostile abdomen during revisional surgery.

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Outcomes of Left-Lobe Donor Hepatectomy for Living-Donor Liver Transplantation: A Single-Center Experience

Cited by 12 publications

References 15 publications

Right lobe donor hepatectomy: is it safe? A retrospective study

Right lobe donor hepatectomy: is it safe? A retrospective study

Postoperative Pulmonary Complications in Living-Liver Donors: A Retrospective Analysis of 188 Patients

Diagnostic and therapeutic management algorithm for biliary complications in living liver donors

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