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Volume: 4 Issue: 2 December 2006 - Supplement - 1

FULL TEXT

DONOR OUTCOME AFTER LIVE LIVER DONATION: A SINGLE CENTER EXPERIENCE

Living-donor Liver Transplantation (LDLT) has been successfully performed at King Faisal Specialist Hospital and Research Center (KFSH&RC). Herein we evaluate the donor outcome and morbidity after donor hepatectomy for LDLT at KFSH&RC. At KFSH&RC, and between April 2001 and August 2006, a total of 43 LDLT procedures were performed (35 adult-to-adult donation and 8 adult-to-child donation). The right lobe (segments 5-6) was used in 35 donors, the left lateral segment (segment 2&3) was used in 7 donors, and the whole left lobe without the caudate lobe (segments 2-4) was used in one donor. The middle hepatic vein was included with the right liver graft in 3 donors. All donors were related to their recipients, median graft-recipient weight ratio (GRWR) was 1.3% (range, 0.8%-2.7%); remaining liver volume was >=30% in all donors; and macro-vesicular steatosis was <=20% as estimated by routine preoperative liver biopsy liver biopsy in all donors. All donors were carefully assessed and approved by a social worker, psychologist and at least one senior member of the surgical team. 43 donors were studied; male/female ratio was 33/10; median age was 25 years (range, 18-42); median hospital stay was 6 days (range, 4-14); and only two donors required perioperative blood transfusion. No donor mortality encountered after a median follow-up period of 529 days (range, 8-1354). Donor morbidities were identified in 9 donors (21%) and they included; sever liver dysfunction due to small remaining liver volume in 2 donors treated with supportive treatment; bile leak in one donor treated with ERCP and stenting; biloma in one donor treated with percutaneous drainage, incisional hernia in one donor treated with laparoscopic mesh repair; skin dehiscence in one patient treated with secondary closure; pressure induced alopecia areata in 3 donors that was self-limiting and required no treatment, and neurapraxia of the right arm in one patient treated with physiotherapy. Psychological disturbances were seen in 2 donors that necessitated psychological counseling. As for the LDLT recipient outcome; after a median follow-up period of 529 days (range, 8-1354), the overall patient and graft survival rates were 88% and 79% respectively (4-retransplants using cadaveric organs).In our experience donor hepatectomy is a relatively safe procedure; however, extreme care should be always given by the transplant teams to live donors in order to avoid any distressing morbidity or even, the less likely but more catastrophic, donor mortality.



Volume : 4
Issue : 2
Pages : 50


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