A donor right hepatectomy is associated with a higher rate of morbidity than a left hepatectomy.
The precise morbidity should be known to improve the success of donor right hepatectomy implementation.
The rate of complication varies according to the individual definition of morbidity.
|78% of donors experienced postoperative complications|
Dr Nam-Joon Yi and colleagues from Korea prospectively analyzed the outcomes of 83 consecutive living donor right hepatectomys between 2002 and 2004.
The team using a standardized classification of the severity of complications.
The morbidity was classified using the modified Clavien system.
Grade 1 included minor complications, and Grade 2 included potentially life-threatening complications requiring pharmacological treatment.
Grade 3 had complications requiring invasive intervention, and Grade 4 for complications causing organ dysfunction requiring intensive care unit management.
Grade 5 complications resulted in the death of the patient.
The donors were followed-up regularly for at least 12 months.
The research team noted no donor death or relaparotomy.
Overall, 78% of donors experienced postoperative complications.
Grades 1, 2, 3, 4, and 5 complications in 77%, 13%, 1%, 0%, and 0% patients, respectively.
The team found that the most common Grade I complications were hyperbilirubinemia in 31 patients.
Pleural effusions were identified in 31 patients, and Grade 2 complications such as bile leakage were found in 7 patients.
The bilirubin and alanine aminotransferase levels were normal in 93% of donors at the 1-year follow-up.
Dr Yi's team concluded, "Although most of these adverse events were minor and self-limited, 78% of right liver donors still experienced morbidity."
"Therefore, continuous standardized reporting of the donor morbidity as well as meticulous surgery and intensive care are essential for the success of donor right hepatectomy implementation."