The Ethics Statement of the Vancouver Forum on the Live Lung, Liver, Pancreas, and Intestine Donor

Pruett, Timothy L.; Tibell, Annika; Al-Abdulkareem, Abdulmajeed; Bhandari, Mahendra; Cronin, David; Dew, Mary Amanda; A, Dib-Kuri; Gutmann, Thomas; Matas, Arthur J.; McMurdo, Lisa; Rahmel, Axel; Rizvi, Syed Adibul Hasan; Wright, Linda; Delmonico, Francis L.

doi:10.1097/01.tp.0000214976.36526.e3

Cited by 130 publications

(94 citation statements)

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“…(1)(2)(3)(4)(5)(6) Morbidities among living donors are reported to be more frequent in right lobectomy than left lobectomy or left lateral sectionectomy. (7) Many transplant programs use a left lobe graft in LDLT to minimize morbidities in living donors.…”

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confidence: 99%

Minimum graft size calculated from preoperative recipient status in living donor liver transplantation

et al. 2016

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Small-for-size graft syndrome is an inevitable complication in living donor liver transplantation (LDLT). We hypothesized that graft weight (GW) measured after graft procurement is one of the variables predicting postoperative graft function. A total of 138 consecutive recipients of adult-to-adult LDLT between March 1999 and October 2014 were included in this study. We investigated the factors associated with small-for-size-associated graft loss (SAGL) to determine the GW required for each patient. Both preoperatively assessed and postoperatively obtained risk factors for SAGL were analyzed in univariate and multivariate logistic regression analysis. Twelve (8.8%) of the transplant recipients had SAGL. In multivariate logistic regression analyses using preoperatively assessed variables, the preoperative Model for End-Stage Liver Disease (MELD) score (P < 0.001) and actual GW/recipient standard liver volume (SLV) ratio (P 5 0.008) were independent predictors of SAGL. Living donor liver transplantation (LDLT) has been established as a lifesaving treatment for end-stage liver disease (ESLD) and acute liver failure, though it is not considered to be as ideal a treatment as deceased donor liver transplantation due to substantial risk of mortality for living donors.(1-6) Morbidities among living donors are reported to be more frequent in right lobectomy than left lobectomy or left lateral sectionectomy. (7) Many transplant programs use a left lobe graft in LDLT to minimize morbidities in living donors. (8,9) However, despite excellent postoperative results using the left lobe, it is not applicable to a certain group of LDLT candidates. We previously reported that a high preoperative Model for End-Stage Liver Disease (MELD) score (10,11) was associated with postoperative graft failure. (12,13) A Kyushu group also pointed out that ESLD patients with high MELD scores are not suitable candidates for LDLT using a left lobe graft because of poor postoperative prognosis. (9,14) A study in Hong Kong reported that acute or chronic hepatitis B virus (HBV)-infected ESLD patients can be rescued by right lobe with middle hepatic vein (MHV) graft in their LDLT series. (15) Graft volume and recipient prognosis are thought to be correlated, and the minimal graft volume required

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confidence: 99%

Minimum graft size calculated from preoperative recipient status in living donor liver transplantation

et al. 2016

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“…The provision of care for living donors before, during, and after surgery, as described in the reports of the international forums organized by the Transplantation Society in Amsterdam and Vancouver (2)(3)(4), is no less essential than taking care of the transplant recipient. A positive outcome for a recipient can never justify harm to a live donor; on the contrary, for a transplant with a live donor to be regarded as a success means that both the recipient and the donor have done well.…”

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The Declaration of Istanbul on Organ Trafficking and Transplant Tourism

2008

Clinical Journal of the American Society of Nephrology

215

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“…Written informed consent was obtained from all the participants and included the items of the Vancouver Forum. (12) This study was conducted in accordance with the Helsinki Declaration of 1975 and was approved by the institutional review board.…”

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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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The Ethics Statement of the Vancouver Forum on the Live Lung, Liver, Pancreas, and Intestine Donor

Cited by 130 publications

References 1 publication

Minimum graft size calculated from preoperative recipient status in living donor liver transplantation

Minimum graft size calculated from preoperative recipient status in living donor liver transplantation

The Declaration of Istanbul on Organ Trafficking and Transplant Tourism

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

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