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Complications after Living Donor Hepatectomy: Analysis of 176 Cases at a Single Center JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS Berglund, D., Kirchner, V., Pruett, T., Mangalick, S., Kandaswamy, R., Serrano, O. K., Benson, B., Mongin, S., Lake, J., Chinnakotla, S. 2018; 227 (1): 24-36

Abstract

Living liver donation is one of the most selfless and humane acts a person can perform. Few single-center reports have been published specifically evaluating complications and quality of life post-donation.We conducted a retrospective analysis of outcomes of 176 living liver donors at our center to determine the incidence, type, and Clavien grade of complications, as well as long-term quality of life.Of 176 living donors, 154 underwent right hepatectomy, 4 underwent left hepatectomy lobectomy, and 18 underwent left lateral segmentectomy. Mean follow-up time was 4.8 years. Complications were more frequent among right-lobe donors than left-lateral segmentectomy and left-lobe donors (p = 0.003). Of note, 82% of complications were Clavien grade 1 or 2. Of the 154 right-lobe donors, 3 had Clavien grade 3a complications, 9 had grade 3b complications (4 had bile leaks, 3 had intra-abdominal bleeding, and 2 had pleural effusions). No donor had complications that were Clavien grade 4 or higher. Per multivariate regression, resected graft volume (p = 0.0498) and post-donation international normalized ratio >2 (p = 0.00499) were significantly associated with a higher risk of Clavien grade 3 complications; however, sex, age, previous abdominal operation, post-donation bilirubin >6 mg/dL, and aspartate transaminase >650 IU/L were not. Per our 36-item Short-Form Health Survey results, donors (mean 8.3 years post-donation) reported above-average quality of life compared with standard US population. In a liver donation survey sent between 1 and 15 years post-donation, the most frequently reported problems were incisional discomfort and intolerance to fatty meals.In our single-center study, early complication rates were comparable with those of multicenter reports. Most complications (82%) were Clavien grade 1 or 2. During a long follow-up period, our donors continue to have improved quality of life.

View details for DOI 10.1016/j.jamcollsurg.2018.03.007

View details for Web of Science ID 000436646700006

View details for PubMedID 29555562