Donor outcome in live-related liver transplantation

Abstract

a b s t r a c tBackground: Live donor liver transplant has become an accepted, effective and lifesaving alternative to deceased donor transplant. The effect on donor and his safety remains a cause of concern. The donors are all in productive age and in our setting may have to go back to active service. This study is aimed at knowing the results of donor hepatectomies at our centre. Results: 35 Donors of age between 20 and 50 years were taken up for procedure of which one was abandoned due to haemodynamic instability after intubation. In the 34 procedures done the percentage of the residual liver was at least 30%. No donor required blood transfusion. The overall complication rate was 26.5% which was stratified according to the modified Clavien classification of postoperative complications. There was transient rise of bilirubin and liver enzymes in all which returned back to normal with time. Infections were the most common cause of complication. All the donors had gone back to their work after a mean of 42 days after surgery. All donors were willing to donate again if needed. Conclusion:Living donor liver transplant a widely practiced modality for end-stage liver disease. It is a safe procedure with good recovery and results. Our study shows that meticulous selection criteria and strict adherence to protocols leads to good outcome. ª 2013, Armed Forces Medical Services (AFMS). All rights reserved.

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.…”

Donor Morbidity Is Equivalent Between Right and Left Hepatectomy for Living Liver Donation: A Meta‐Analysis

“…Regarding the mixed-effects model comparing left versus right + MHV, results should be interpreted with caution because only 2 studies provided data for the right lobe + MHV. (30,47) Although not proven by this study, a potential reason why right lobe donation is associated with higher overall complication rate might be related to or driven by those grafts that do include the MHV. In these types of grafts the amount of parenchyma resected is bigger and the outflow drainage of the remnant liver only depends on the left hepatic vein.…”

Different techniques for harvesting grafts for living donor liver transplantation: A systematic review and meta-analysis

“…Since then, the feasibility and safety of pediatric LDLT have been well documented[ 4 ]. Donor safety is considered paramount, as donor hepatectomy is a major surgery for healthy individuals[ 5 ]. However, the large permanent abdominal incision scar resulting from conventional open surgery may cause mental and physical stress among some putative living donors, especially young unmarried women, resulting in hesitation or unwillingness to donate liver tissue[ 4 , 6 ].…”