The true extent of morbidity among live liver donors remains poorly understood.
The development of standards for defining and reporting complications would foster a better understanding of the incidence and magnitude of such adverse events.
Dr Christopher Shackleton and colleagues conducted a retrospective review of adverse events among live liver donors.
Of 202 individuals undergoing evaluation for live liver donation, 42 proceeded to surgery.
|95% of adverse events occurred in the first postoperative month|
|Archives of Surgery|
The researchers reported that 34 patients underwent a right lobectomy without the middle hepatic vein, and that 3 had a left lateral segmentectomy.
Any event causing a deviation from a patient's ideal course was considered an adverse event and subsequently classified according to a derived framework.
The research team defined morbidity as 1 or more adverse event.
The main outcome measures included incidence, timing, type, severity, and impact of adverse events.
The team reported that no deaths or significant hepatic dysfunction occurred.
In 5 of the 42 donors, the hepatectomy was aborted for anatomic reasons before parenchymal transection.
The researchers found that 8 of the remaining 37 patients experienced 11 adverse events, of which 10 were completely resolved.
The team noted that 1 adverse event resulted in a permanent disability with brachial plexopathy.
The overall incidence of adverse events was 0.3 per case.
The researchers observed that 10 of the 11 adverse events presented within the first postoperative month.
Dr Shackelton's team commented, “Most live liver donations are uncomplicated or do not lead to permanent consequence.”
“The adoption of a standards-based classification framework for adverse events in live liver donors would allow for an inclusive, consistent, and universally applicable method to collect, analyze, and report donor morbidity.”