Donor safety should be the primary focus in living donor liver transplantation. Although, the procedure carries a significant risk of morbidity and even mortality, the use of marginal liver donors have become a current discussion issue. Between September 2001 and August 2008, we performed 190 LDLT at our center. Of 190 donors, 109 were male and 81 were female, with a mean donor age of 34.5±9 (range 19-66). One-hundred-forty-one of the donors were first degree relatives of the recipients, 33 were second degree relatives and 16 were spouses. We performed 90 right lobe, 36 left lobe and 64 left lateral segmentectomies (LLS). For the right lobe grafts, median hepatic vein was always left in the remnant liver. The mean ratios of remnant liver to the total liver volume of the donor were 42, 66.8 and 74.6% for the right, left lobe and LLS donors, respectively. The mean hospitalization periods were 7, 6.2 and 9.7 days with the same order, and the mean operation times were 330, 324 and 324 minutes. Only 15 donors (7.8%) received autologous blood transfusions during the surgery. Liver function tests including ALT, AST, bilirubine, PTT, thrombocyte levels were assessed at 1st, 3rd and 5th postoperative days, then at the time of outpatient follow-up, usually at the 3rd week. There was no postoperative mortality and 13 complications occurred in 10 of the 190 donors (5.2%) in which most of them were treated with radiologic interventions. In conclusion, although we did not accept grafts with remnant volumes less than 40%, graft type had a negative influence on postoperative liver function tests. Larger graft causes impaired functions in the early postoperative period, however does not have a negative impact on the long term. The remnant volume should be measured fastidiously and surgeons should avoid taking large volumes especially for the right lobe donors.
Volume : 6
Issue : 4
Pages : 26
Department of General Surgery and Transplantation, Baskent University Faculty of Medicine, Ankara, Turkey.