Improving outcomes of living-donor right hepatectomy

Kim, S. H.; Kim, Y. K.

doi:10.1002/bjs.9022

Cited by 54 publications

(62 citation statements)

References 30 publications

(35 reference statements)

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“…17,[29][30][31] In our study, the complication rates were 11.4% in the PPN group and 35% in the control group (P = .015), indicating that PPN treatment can reduce the rate of postoperative complications. The major complications in our patients were bile leakage, wound infection, wound seroma, pleural effusion, and atelectasis.…”

Section: Chia-en Hsieh Et Al/experimental and Clinical Transplantatiomentioning

confidence: 49%

Untitled

2015

Exp Clin Transplant

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Section: Chia-en Hsieh Et Al/experimental and Clinical Transplantatiomentioning

confidence: 49%

Untitled

2015

Exp Clin Transplant

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“…Both these patients have done well on follow-up with normal LFT and clinical course. The role of the IOC has been questioned recently in a series (15) in which the authors have stopped performing IOC without any increase in biliary complications. It has been highlighted that the transection of the right duct should be performed 2 mm to the right of CHD-RHD junction in order to avoid stricturing and stump-related biliary complications.…”

Section: Discussionmentioning

confidence: 99%

Biliary complications after living donor hepatectomy: A first report from India

Pamecha¹,

Bharathy²,

Kumar³

et al. 2016

Liver Transpl

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Biliary complications after donor hepatectomy can result in significant morbidity. We herein present our experience of donor hepatectomy, highlighting surgical techniques that prevent complications. Data were reviewed from a prospectively maintained database of all donors who underwent hepatectomy from April 2011 to April 2015. Standard operative technique as described was followed in all patients. Biliary complications and morbidity were recorded and stratified as per Clavien-Dindo classification. Results were compared with published literature. During the study period, 160 donors underwent hepatectomy. The majority of the graft types were right hemiliver without the middle hepatic vein (71.9%). Major complications (grade III and above) occurred in 5.6% of the donors. There was no donor mortality. Only 1 out of the 160 donors (0.6%) has had a grade III biliary complication requiring endoscopic retrograde cholangiography and papillotomy. There were 3 grade II biliary complications, all occurring after left lateral sectionectomy, necessitating prolonged retention of the intra-abdominal drain. The median duration of hospital stay was 11 days (range, 5-67 days), and the duration of follow-up was 16 months (range, 3-52 months). There was no loss to follow-up, and no donor required readmission or outpatient procedures for any biliary complication. In conclusion, with careful donor selection and a standardized surgical technique, biliary complications can be minimized.

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“…Various modifications in surgical technique and management (3,7,8) resulted in the current morbidity less than 3% without any major complications, reoperation or blood transfusions for more than 300 LDRHs since 2010. The majority of LDRHs were completed less than 3 h with the shortest at 106 min.…”

Section: Discussionmentioning

confidence: 99%

“…The donor selection criteria and evaluation have been described elsewhere (3,13,14). At the very beginning of our LDLT program in January 2005, the upper age limit was 59 years, and then, after overcoming the learning curve (13), elderly donors aged !60 have been carefully accepted since March 2008 by the selection criteria: preservation of middle hepatic vein, a remnant liver volume !30% and no or mild fatty change in healthy condition.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, advances in surgical technique and management have resulted in improved outcome of living donor right hepatectomy (LDRH) (3). It was reported that short and mid-term survival following liver transplantation using deceased donors !70 years old can be excellent provided that there is adequate donor and recipient selection (4).…”

Section: Introductionmentioning

confidence: 99%

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Successful Living Donor Liver Transplantation Between Septuagenarians

Kim

Lee

et al. 2015

American Journal of Transplantation

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We report a case of a 76-year-old female who underwent living donor right hepatectomy for her 75-year-old husband with recurrent hepatocellular carcinoma. With her voluntary decision, full medical and psychiatric assessment was performed. The operative time was 130 min in the donor and 399 min in the recipient. Both the donor and recipient had an uneventful recovery and were discharged on days 7 and 10, respectively with normal liver function. The couple has had no complication so far and is currently doing well in good health 26 months after living donor liver transplantation.

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Improving outcomes of living-donor right hepatectomy

Abstract: This study suggests that near-zero morbidity may be reached after right hepatectomy in carefully selected living donors by continuous refinement of surgical technique and management.

Cited by 54 publications

References 30 publications

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Biliary complications after living donor hepatectomy: A first report from India

Successful Living Donor Liver Transplantation Between Septuagenarians

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