Donor Complication in Living Donor Liver Transplantation

Jae Do Yang; Hee Chul Yu

doi:10.4285/jkstn.2017.31.4.177

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Yang and Yu: Donor Complication in Living Donor Liver Transplantation

Review Article

The Journal of the Korean Society for Transplantation 2017; 31(4): 177-181.

Published online: 31 December 2017

DOI: https://doi.org/10.4285/jkstn.2017.31.4.177

Donor Complication in Living Donor Liver Transplantation

Jae Do Yang, M.D., Hee Chul Yu, Ph.D.

Department of Surgery, Chonbuk National University Medical School, Jeonju, Korea.

Corresponding author: Hee Chul Yu. Department of Surgery, Chonbuk National University Medical School, Gungi-ro, Deokjin-gu, Jeonju 54907, Korea. Tel: 82-63-250-1576, Fax: 82-63-271-6197, hcyu@chonbuk.ac.kr

Received 22 December 2017 Accepted 23 December 2017

Rhe Korean Society for Transplantation

Abstract

Living donor liver transplantation (LDLT) has become an inevitable procedure due a shortage of deceased donors under the influence of religious and native cultures. The most important concern in LDLT is donor safety. This study reviewed the safety of LDLT donors from reported studies of morbidity and mortality. Many studies have reported mortality and morbidity rates ranging from 0% to 33% for healthy liver donors. Use of laparoscopic surgery on LDLT donors has advantages of reduced blood loss, lower postoperative morbidity and shorter hospital stay relative to conventional open surgery. There is a consensus that remnant liver volume (RLV), degree of steatosis, and donor age are the most important factors influencing donor safety. In LDLT, donor hepatectomy can be performed successfully with minimal and easily controlled complications. However, a large-scale prospective cohort study is needed to better understand the risk factors and accurately determine the complication rates for LDLT.

Keywords: Living donor liver transplantation, Patient safety, Postoperative complication

Figures and Tables

Table 1

Donor complications according to graft types among 832 living donors

Data are given as n (%). The LG was composed of patients who donated a left lateral segment (or mono segment), left lobe, or extended left lobe graft. The RG was composed of patients who donated a right posterior section, right lobe, or extended right lobe.

^aP values were calculated according to all graft types using Fisher's exact test; ^bP values of LG versus RG comparisons were calculated using Fisher's exact test; ^cMajor complications were defined as those of Clavien grade III or more.

Table 2

Results of the studies on pure laparoscopic living donor major hepatectomy

^aDefined higher than grade II Clavien classification; ^bIsolated right posterior duct treated with Roux-en-Y hepaticojejunostomy; ^cThe results were not reported separately, included 17 left lateral sectionectomy group; ^dHernia (n = 1) and bile leak (n = 1); ^eBiliary fistula required ERBD and PCD (n=2).

Abbreviations: Cx, complications; LOS, length of stay; WIT, warm ischemic time.

Table 3

Results of the comparative studies on laparoscopy-assisted donor right hepatectomy with case-matched open donor hepatectomy

^aDened higher than grade II Clavien classication; ^bDened vascular and biliary Cx; ^cSmall bowel injury (n=1) and biloma due to wound dehiscence (n=1); ^dHepatic artery thrombosis (n=2), portal vein thrombosis (n=1), and biliary Cx (n=12); ^eBleeding required reoperation; ^fHepatic artery thrombosis (n=1), biliary stricture (n=1) and bleeding (n=1); ^gPleural effusion required drainage; ^HBiliary stricture (n=1) and bile leak (n=1).

Abbreviations: Cx, complications; LOS, length of stay.

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