title: Analysis and outcomes of right lobe hepatectomy in 101 consecutive living donors.
abstract: The shortage of deceased organ donors has created a need for right lobe living donor liver transplantation (RLDLT) in adults. Concerns regarding donor safety, however, necessitate continuous assessment of donor acceptance criteria and documentation of donor morbidity. We report the outcomes of our first 101 donors who underwent right lobectomy between April 2000 and November 2004. The cohort comprised 58 men and 43 women with a median age of 37.8 years (range: 18.6-55 years); median follow-up is 24 months. The middle hepatic vein (MHV) was taken with the graft in 55 donors. All complications were recorded prospectively and stratified by grade according to Clavien's classification. Overall morbidity rate was 37%; all complications were either grade 1 or 2, and the majority occurred during the first 30 days after surgery. Removal of the MHV did not affect morbidity rate. There were significantly fewer complications in the later half of our experience. All donors are well and have returned to full activities. With careful donor selection and specialized patient care, low morbidity rates can be achieved after right hepatectomy for living donor liver transplantation.
authors.affiliation: Department of Surgery, Multiorgan Transplantation Program, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Shimul A
authors.initials: SA
authors.lastname: Shah
authors.forename: David R
authors.initials: DR
authors.lastname: Grant
authors.forename: Paul D
authors.initials: PD
authors.lastname: Greig
authors.forename: Ian D
authors.initials: ID
authors.lastname: McGilvray
authors.forename: Leslie D
authors.initials: LD
authors.lastname: Adcock
authors.forename: Nigel
authors.initials: N
authors.lastname: Girgrah
authors.forename: Philip
authors.initials: P
authors.lastname: Wong
authors.forename: Robin D
authors.initials: RD
authors.lastname: Kim
authors.forename: Robert
authors.initials: R
authors.lastname: Smith
authors.forename: Leslie B
authors.initials: LB
authors.lastname: Lilly
authors.forename: Gary A
authors.initials: GA
authors.lastname: Levy
authors.forename: Mark S
authors.initials: MS
authors.lastname: Cattral
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005190:Family; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008099:Liver / Q000033:anatomy & histology; D008111:Liver Function Tests; D019520:Living Donors; D008297:Male; D009864:Ontario; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D018454:Spouses; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome