Chung-Mau Lo and colleagues examined 100 consecutive adult right lobe living donor liver transplants (LDLT) performed between May 1996 and May 2002.
The LDLTs were studied retrospectively, to determine whether the numerous modifications in technique and better experience would improve results.
The first 50 patients (group 1) were compared with the last 50 patients (group 2), with a median follow-up of 37 (27 to 79) months and 15 (7 to 27) for each group respectively.
The characteristics of donors and liver grafts were similar. However, in group 2 fewer recipients required a visit to an intensive care unit or had hepatorenal syndrome before transplantation. There was also a lower disease severity as shown by a lower Child-Pugh score and Model for End-Stage Liver Disease (MELD) score.
| "There is a learning curve in adult right lobe LDLT"
| Dr Chung-Mau Lo, Annals of Surgery|
In both operation line, blood loss, ICU stay and postoperative complication rate of the donors significant improvements were noted in group 2.
In addition, operation time, transfusion requirements, number of reoperations, ICU stay and hospital stay were all also lower for group 2 compared to group 1.
The hospital mortality rate of recipients was reduced from 16% to 0%, while graft survival rates at 12 months and 24 months were improved from 80% and 74%, respectively, in group 1, to 100% and 96%, respectively, in group 2.
Commenting on the findings, Dr Lo concluded, "There is a learning curve in adult right lobe LDLT. The results have significantly improved with technical refinement and better experience."