title: Morbidity in live liver donors: standards-based adverse event reporting further refined.
abstract: OBJECTIVE
  The true extent of morbidity among live liver donors remains poorly understood. In this unique and often high-profile area of surgery, the development of standards for defining and reporting complications would foster a better understanding of the incidence and magnitude of such adverse events (AEs).
  
  
  METHODS
  Retrospective review of AEs among live liver donors.
  
  
  METHODS
  University-affiliated teaching hospital.
  
  
  METHODS
  Of 202 individuals undergoing evaluation for live liver donation, 42 (20.8%) proceeded to surgery. Thirty-four underwent a right lobectomy without the middle hepatic vein; 3, a left lateral segmentectomy. Any event causing a deviation from a patient's ideal course was considered an AE and subsequently classified according to a derived framework. Morbidity was defined as 1 or more AEs.
  
  
  METHODS
  Incidence, timing, type, severity, and impact of AEs.
  
  
  RESULTS
  No deaths or significant hepatic dysfunction occurred. In 5 (12%) of the 42 donors, the hepatectomy was aborted for anatomic reasons before parenchymal transection. Eight (22%) of the remaining 37 experienced 11 AEs, of which 10 completely resolved, whereas 1 AE (3%) resulted in a permanent disability (brachial plexopathy). The overall incidence of AEs was 0.30 per case. Ten (91%) of the 11 AEs presented within the first postoperative month.
  
  
  CONCLUSIONS
  Most live liver donations are uncomplicated or do not lead to permanent consequence. The adoption of a standards-based classification framework for AEs in live liver donors would allow for an inclusive, consistent, and universally applicable method to collect, analyze, and report donor morbidity.
authors.affiliation: Center for Liver Diseases and Transplantation, Cedars-Sinai Medical Center, and Department of Surgery, The David Geffen School of Medicine at UCLA, USA. shackletonc@thelivercenter.org
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Shackleton
authors.forename: John M
authors.initials: JM
authors.lastname: Vierling
authors.forename: Nicholas
authors.initials: N
authors.lastname: Nissen
authors.forename: Paul
authors.initials: P
authors.lastname: Martin
authors.forename: Fred
authors.initials: F
authors.lastname: Poordad
authors.forename: Tram
authors.initials: T
authors.lastname: Tran
authors.forename: Steven D
authors.initials: SD
authors.lastname: Colquhoun
mesh_terms: D000328:Adult; D005260:Female; D006498:Hepatectomy; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012308:Risk Management / Q000592:standards*