Living-Donor Liver Transplantation: Donor Selection Criteria and Postoperative Outcomes. A Single-Center Experience With a 10-Year Follow-up

Lauterio, Andrea; Poli, Caroline; Cusumano, Caterina; Sandro, Stefano Di; Tripepi, Matteo; Mangoni, I.; Mihaylov, Plamen; Concone, Giacomo; Giacomoni, Alessandro; Carlis, Luciano Gregorio De

doi:10.1016/j.transproceed.2013.07.037

Cited by 13 publications

(27 citation statements)

References 16 publications

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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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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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“…Since LDLT was first introduced in Italy in 2001 for adult recipients, its risks have not been fully addressed. The lack of a national registry limits comprehensive data on donor morbidity, and most available information stems from single‐center series . In 2014, 7 Italian transplant centers involved in LDLT (listed in the Supporting Information) signed a cooperative research agreement with the specific aim to provide accurate and transparent information on the risks and benefits of LDLT in both donors and recipients.…”

mentioning

confidence: 99%

“…The lack of a national registry limits comprehensive data on donor morbidity, and most available information stems from single-center series. (6)(7)(8) In 2014, 7 Italian transplant centers involved in LDLT (listed in the Supporting Information) signed a cooperative research agreement with the specific aim to provide accurate and transparent information on the risks and benefits of LDLT in both donors and recipients. The current report retrospectively analyzed the predictors associated with donor postoperative complications and outcomes after LDLT in the 7 transplant centers.…”

mentioning

confidence: 99%

Donor safety in living donor liver donation: An Italian multicenter survey

et al. 2016

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Major concerns about donor morbidity and mortality still limit the use of living donor liver transplantation (LDLT) to overcome the organ shortage. The present study assessed donor safety in LDLT in Italy reporting donor postoperative outcomes in 246 living donation procedures performed by 7 transplant centers. Outcomes were evaluated over 2 time periods using the validated Clavien 5-tier grading system, and several clinical variables were analyzed to determine the risk factors for donor morbidity. Different grafts were obtained from the 246 donor procedures (220 right lobe, 10 left lobe, and 16 left lateral segments). The median follow-up after donation was 112 months. There was no donor mortality. One or more complications occurred in 82 (33.3%) donors, and 3 of them had intraoperative complications (1.2%). Regardless of graft type, the rate of major complications (grade ≥ 3) was 12.6% (31/246). The overall donor morbidity and the rate of major complications did not differ significantly over time: 26 (10.6%) donors required hospital readmission throughout the follow-up period, whereas 5 (2.0%) donors required reoperation. Prolonged operative time (>400 minutes), intraoperative hypotension (systolic < 100 mm Hg), vascular abnormalities, and intraoperative blood loss (>300 mL) were multivariate risk factors for postoperative donor complications. In conclusion, from the standpoint of living donor surgery, a meticulous and well-standardized technique that reduces operative time and prevents blood loss and intraoperative hypotension may reduce the incidence of donor complications. Transparency in reporting results after LDLT is mandatory, and we should continue to strive for zero donor mortality. Liver Transplantation 23 184-193 2017 AASLD.

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“…Although LDLT has helped to resolve the problems of many patients, donors themselves gain no medical benefits, but incur the risks of surgical complications, sometimes with negative psychosocial consequences. Reports have shown that 40% of the living liver donors report psychological distress after surgery (12,37,(43)(44)(45). Our experience shows that donor complications and negative recipient outcomes are major causes of psychological distress.…”

Section: Discussionmentioning

confidence: 67%

Complications and outcomes of 890 living liver donor hepatectomies at a single center: risks of saving loved one’s life

et al. 2020

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Living-Donor Liver Transplantation: Donor Selection Criteria and Postoperative Outcomes. A Single-Center Experience With a 10-Year Follow-up

Cited by 13 publications

References 16 publications

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

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

Donor safety in living donor liver donation: An Italian multicenter survey

Complications and outcomes of 890 living liver donor hepatectomies at a single center: risks of saving loved one’s life

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