title: Intraoperative blood loss is a risk factor for complications in donors after living donor hepatectomy.
abstract: Complications in a donor are a distressing but inevitable occurrence, since graft procurement is a major undertaking. Although the technique for procurement has some similarities to hepatic resection, a donor is very unlike a patient with malignancy. The risk factors identified in these patients cannot be extrapolated to donors. Donor hepatectomy carried out from June 1995 to March 2005 in Chang Gung Memorial Hospital, Kaohsiung Medical Center was reviewed with the aim of identifying risk factors for complications. There were 204 living donor liver transplants, with 205 donor hepatectomies, as 1 living donor liver transplantation was a dual graft. Ten donors (4.88%) suffered complications. There was no difference in terms of age, gender, body weight, operation, and parenchymal time between those who had complications and those who did not. There was also no difference in liver function tests between the 2 groups of donors, but the total bilirubin was significantly higher in donors with complications. The graft weight and remnant liver volume were also similar. The proportion of donors with fatty liver was the same between the 2 groups. The mean blood loss in donors with complications was 170 +/- 79 mL, and that for donors without complications was 95 +/- 77 mL. There was a statistically significant greater blood loss in donors with complications (P < 0.05). The number of segments removed in donors with complications was also higher compared to donors without complications (P < 0.03). Using multivariate analysis, intraoperative blood loss and the number of segments removed were found to be independent risk factors for donor complications. Intraoperative blood loss during graft procurement must be kept low to minimize complications in donors.
authors.affiliation: Department of Surgery, Liver Transplant Program, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan.
authors.forename: Salleh
authors.initials: S
authors.lastname: Ibrahim
authors.forename: Chao-Long
authors.initials: CL
authors.lastname: Chen
authors.forename: Chih-Che
authors.initials: CC
authors.lastname: Lin
authors.forename: Chin-Hsiang
authors.initials: CH
authors.lastname: Yang
authors.forename: Chih-Chi
authors.initials: CC
authors.lastname: Wang
authors.forename: Shih-Ho
authors.initials: SH
authors.lastname: Wang
authors.forename: Yeuh-Wei
authors.initials: YW
authors.lastname: Liu
authors.forename: Chee-Chien
authors.initials: CC
authors.lastname: Yong
authors.forename: Allan
authors.initials: A
authors.lastname: Concejero
authors.forename: Bruno
authors.initials: B
authors.lastname: Jawan
authors.forename: Yu-Fan
authors.initials: YF
authors.lastname: Cheng
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D005260:Female; D006498:Hepatectomy; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D011183:Postoperative Complications; D012307:Risk Factors