Liver regeneration and surgical outcome in donors of right-lobe liver grafts.
BACKGROUND
Previous studies of healthy live-liver donors have suggested that complete liver regeneration occurs within a matter of weeks; however, there have been no long-term studies evaluating liver regeneration and few studies documenting long-term donor outcome.


METHODS
Fifty-one donors who provided right-lobe grafts underwent volumetric spiral computed tomography scans preoperatively and postoperatively at time intervals of 1 week and 1, 3, 6, and 12 months. Patient demographics, surgical data, and postoperative outcome were correlated with liver regeneration data. Donor surgical outcome was followed prospectively and recorded in a comprehensive database.


RESULTS
Thirty-three males and 18 females (mean age 36.0+/-9.6 years) provided 51 right-lobe grafts. Mean follow-up was 9.8+/-3.4 months. No donor operation was aborted, and surgical morbidity and mortality rates were 39% and 0%, respectively. Donor remnant liver volume was 49.4+/-5.7% of the original total liver volume (TLV). Overall liver regeneration was 83.3+/-9.0% of the TLV by 1 year. Female donors had significantly slower liver regrowth when compared with males at 12 months (79.8+/-9.3% vs. 85.6+/-8.2%, P<0.01). There was no effect of age, body mass index, operative time, estimated blood loss, postoperative complications, or perioperative liver function tests on liver regeneration.


CONCLUSIONS
Liver regeneration continues throughout the first postoperative year. Only one donor achieved complete liver regeneration during this time period; however, all donors have maintained normal liver function without long-term complications. Longer follow-up is needed to determine whether donors ever achieve original TLV.
Pomfret
Elizabeth A
EA
Division of Liver Transplantation and Hepatobiliary Surgery, Lahey Clinic Medical Center, Burlington MA 01805, USA. Elizabeth.A.Pomfret@ lahey.org.
Pomposelli
James J
JJ
Gordon
Fredric D
FD
Erbay
Nazli
N
Lyn Price
Lori
L
Lewis
W David
WD
Jenkins
Roger L
RL
D000293:Adolescent; D000328:Adult; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008099:Liver / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D008111:Liver Function Tests; D008115:Liver Regeneration / Q000502:physiology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total; D018579:Patient Selection; D012189:Retrospective Studies; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome