Patients considering living donor liver transplantation need to know the risk and severity of complications compared to deceased donor liver transplantation.
One aim of the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL) was to examine recipient complications following these procedures.
Dr Freise and team from California, USA reviewed medical records of deceased donor liver transplantation or living donor liver transplantation recipients who had a living donor evaluated at the nine A2ALL centers between 1998 and 2003.
The research team evaluated 384 living donor liver transplantations, and 216 deceased donor liver transplantations.
|2 complications occurred after deceased donor liver transplantations|
|American Journal Transplantation|
At least one complication occurred after 83% of living donor liver transplantations and 78% of deceased donor liver transplantations.
There was a median of 2 complications after deceased donor liver transplantations, and 3 after living donor liver transplantations.
The researchers found complications that occurred at a higher rate after living donor liver transplantations included biliary leak, unplanned reexploration, hepatic artery thrombosis, and portal vein thrombosis.
The team noted that there were more complications leading to retransplantation or death after living donor liver transplantation versus deceased donor liver transplantation.
Many complications occurred more commonly during early center experiences.
The odds of grade 4 complications were more than 2-fold higher when centers had performed 20 living donor liver transplantations.
Dr Freise’s team concluded, “In summary, complication rates were higher after living donor liver transplantation versus deceased donor liver transplantation.”
“However, these declined with center experience to levels comparable to deceased donor liver transplantation.”