Complications of Living Donor Hepatic Lobectomy—A Comprehensive Report

Abécassis, Michaël; Fisher, Robert A.; Olthoff, Kim M.; Freise, Christopher E.; Rodrigo, Del R.; Samstein, Benjamin; Kam, Igal; Merion, Robert M.

doi:10.1111/j.1600-6143.2011.03972.x

Cited by 315 publications

(320 citation statements)

References 10 publications

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“…They also confirmed that increasing center experience was not associated with a reduction in complication rates. 12 In our study, the overall postoperative complication rate was 19.5%. Our overall complication rate seems in the median of those reported from the United States and Far East countries.…”

Section: Discussionmentioning

confidence: 48%

“…10 Similarly, no PAP cases were reported in the A2ALL consortium study, which included 707 living liver donors from the United States. 12 Also, we have not reported any PAP cases in our previous study, which included 500 consecutive donors between 2007 and 2011. 34 To our knowledge, until now, the highest rate of PAP in living liver donors was reported by Morioka and associates.…”

Section: Adil Baskiran Et Al/experimental and Clinical Transplantatiomentioning

confidence: 93%

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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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Section: Discussionmentioning

confidence: 48%

Section: Adil Baskiran Et Al/experimental and Clinical Transplantatiomentioning

confidence: 93%

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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“…Although open living donor hepatectomy is still the standard procedure for adult LDLT (6,8), different strategies have been designed in order to do donor surgery less invasively. Basically, they involve a short midline or subcostal incision with or without previous laparoscopic mobilization of the lobe (8)(9)(10)(11)(12)(13)(14).…”

Section: Discussionmentioning

confidence: 99%

“…We discussed with donors and recipients that the procedure is novel and had not previously been used for full hemilobe grafts. We discussed with donors the mortality and morbidity based on previous published studies as well as our own center data (6,7). It was detailed proposed to the donors, who gave written consent.…”

Section: Donors and Methodsmentioning

confidence: 99%

Totally Laparoscopic Full Left Hepatectomy for Living Donor Liver Transplantation in Adolescents and Adults

Samstein

Cherqui

Rotellar³

et al. 2013

American Journal of Transplantation

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In recent years different minimal access strategies have been designed in order to perform living donor liver surgery for adult recipients with less morbidity. Techniques involve shortening the length of the incision with or without previous laparoscopic mobilization of the liver. Herein we present two cases of totally laparoscopic living donor left hepatectomy, with and without removal of the middle hepatic vein, respectively. We describe in detail the anatomical and technical aspects of the procedure focusing on relevant points to enhance safety.Key words: Adult, laparoscopy, left lobe graft, live donor transplantation, liver transplantation Abbreviations: GRWR, graft to recipient weight ratio; LDLT, means living donor liver transplant; LHV, left hepatic vein; MHV, middle hepatic vein.

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“…Specifically, donor mortality has been estimated around 0.1-0.3% for right lobe grafts 53,54 , while the reported risk of donor fatal complication is around 2-10% [55][56][57] .LDLT comprises the majority of liver transplantations performed in Asian countries in contrast to Western countries 58 . This however does not mean that we should take lightly this type of donation, as we are referring to donors who are healthy and enter a surgery where there will be no benefit to their health, a truly altruistic act.…”

Section: Emerging Challenges In Liver Transplantationmentioning

confidence: 99%

The Evolution of Criteria for Liver Transplantation for Hepatocellular Carcinoma: From Milan to San Francisco and All Around the World!

Ziogas¹,

Tsoulfas²

2017

RFMH

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Introduction: Hepatocellular carcinoma (HCC) is the fifth most common malignancy and the third most common cancerrelated cause of death in the world. According to the stage of the disease, each patient is allocated to a different treatment option. Liver transplantation, along with surgical resection, is the only totally therapeutic option and is primarily indicated in HCC patients with underlying cirrhosis. However, the restricted number of liver grafts imposes difficulties in selecting the most suitable patients to receive those limited grafts and therefore certain criteria have been proposed. The Milan criteria are currently the most widely accepted and utilized criteria around the world, despite their restrictiveness. In an attempt to assist HCC patients exceeding them, but with a potential to display acceptable survival outcomes, undergo liver transplantation, research teams worldwide suggest expanded criteria based on their findings. Some of the most broadly known are the University of California, San Francisco (UCSF), Kyoto, Tokyo, Hangzhou and up-to-7 criteria. On the other hand, in order to expand the liver donor pool, grafts may be accepted from living, non-heart beating, elderly, steatotic, or even HCV-infected donors, in addition to the use of split livers with both advantages and disadvantages. The aim of this review is to thoroughly present the current situation of liver transplantation for HCC patients, with a focus on the criteria used and emerging challenges presented. Core tip: Hepatocellular carcinoma (HCC) is the third most common malignancy worldwide and liver transplantation represents the treatment of choice, particularly in the setting of cirrhosis. Lack of grafts led to the utilization of certain criteria in order to determine the eligibility of an HCC patient to access the waiting list. The most widely accepted are the Milan criteria, even though they are thought off as too restrictive. Consequently, transplant research groups all over the world published their own criteria, which showed acceptable outcomes. Living donor liver transplantation and other extended-criteria grafts have been proposed as an alternative to reduced donations. Ziogas IA, Tsoulfas G. The evolution of criteria for liver transplantation for hepatocellular carcinoma: from Milan to San Francisco and all around the world!

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Complications of Living Donor Hepatic Lobectomy—A Comprehensive Report

Cited by 315 publications

References 10 publications

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

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

Totally Laparoscopic Full Left Hepatectomy for Living Donor Liver Transplantation in Adolescents and Adults

The Evolution of Criteria for Liver Transplantation for Hepatocellular Carcinoma: From Milan to San Francisco and All Around the World!

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