A main concern after living donor liver transplantation is the risk of morbidity and/or mortality that it imposes on the donors.
Respiratory postoperative complications in living liver donors have already been reported but their frequency seems to be underestimated.
Dr Federica Dondero and colleagues evaluated the rate and nature of postoperative pulmonary complications in 112 consecutive donors.
The researchers conducted a prospective study and reviewed the medical records of the living donors operated on at their center from 1998 to 2003.
All the cases of respiratory complications were retrieved.
|Respiratory complications developed in 10% of all donors|
The research team reported that since 2000, all patients had a computed tomography angiography of the thorax at day 7 on a prospective basis.
In all, 112 hepatectomies for adult-to-adult or adult-to-child liver donation were performed.
The team observed no postoperative mortality.
The researchers found that respiratory complications developed in 10% of all donors, after right hepatectomy.
The respiratory complications included nonsevere pulmonary embolism, right pleural empyema, and bacterial pneumonia.
The team noted that minor respiratory complications occurred in 7% of the donors.
These included iatrogenic pneumothorax, and pleural effusion requiring thoracocentesis.
The researchers found that abdominal complications developed in 9% of donors, who in the vast majority remained free of pulmonary complications.
Dr Dondero's team concludes. “In our series, pulmonary complications are frequent in living liver donors.”
“These complications are mainly observed after right hepatectomy.”
“The particular prevalence of pulmonary embolism should lead to focus on its early diagnosis and prevention.”