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 17 January 2018

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News

Surgery-related morbidity in living donors of right-lobe liver graft

Complications occur in a significant proportion of right-lobe liver graft donors, find investigators in the latest issue of Transplantation.

News image

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Living-donor liver transplantation (LDLT) using the left lateral segment or left-lobe graft is widely accepted. However, right-lobe grafts are commonly used in many LDLT programs.

The risks for the donors of right-lobe grafts are unknown.
75 complications were identified in 69 donors.
Transplantation

In this study, researchers from Japan assessed 200 donors of right-lobe grafts. They focused on the incidence and variety of surgery-related morbidity.

The team evaluated changes in liver function tests to clarify the relation with donor age, steatosis of the liver, and residual liver volume (RLV).

Complications were surveyed for a median period of 28.7 months.

The physicians found that liver enzymes and bilirubin normalized within 1 month in all donors.

However, enzymes in older donors, those with macrovesicular steatosis, or with larger RLV, were significantly higher on day 1.

The team also determined that bilirubin on day 1 was significantly higher in donors with smaller RLV.

In addition, they found that biliary enzyme was not normalized in the majority at 1 month after donation.

Overall, the team identified 75 complications in 69 donors.

Of these, they found that biliary complications were the most common. These consisted of bile leakages (13%) and biliary strictures (2%), in 27 donors.

However, no complications led to mortality or to long-term sequelae.

Dr Takashi Ito's team concluded, "Complications occurred in a significant proportion of right-lobe donors irrespective of donor age, BMI, estimated RLV, and medical history".

"Living-liver donor surgery requires more care in right-lobe transplants".

Transplantation 2003; 76(1): 158-63
21 July 2003

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