Donor outcome after living liver donation: a single-center experience.
OBJECTIVE
To objectively evaluate outcomes after living donor hepatectomy.


METHODS
Between November 2002 and August 2006, a total of 44 procedures were performed (35 right, eight left, and one aborted after surgical incision). The Clavien classification was used to record surgical complications as follows: grade I, alterations from the ideal postoperative course not requiring specialized pharmacological or surgical treatment; grade II, complications requiring specialized pharmacological treatment, blood transfusion, or total parental nutrition; grade III-a, complications requiring invasive intervention without general anesthesia; Grade III-b, requires general anesthesia; Grade IV-a, single organ dysfunction; Grade IV-b, multiorgan dysfunction; grade V, death; The suffix "d" indicated disability. In this study, grades I and II complications were considered minor, while grades III and V and any lasting disability, serious complications.


RESULTS
Male/female ratio was 34/10; median age was 25 years (range, 18 to 42); median hospital stay was 6 days (range, 4 to 14); and only two donors required intraoperative blood transfusion. After a median follow-up of 529 days (range, 8 to 1354), a total of 28 morbidities were encountered in 17 donors (38.6%), including nine donors (20.4%) who had serious complications. Among the 28 donor morbidities, 18 were grade I complications; three were grade III-a complications; five were grade III-b complications; and two were grade IV-a complications. No death was encountered in our experience.


CONCLUSIONS
In our experience, donor hepatectomy was not an entirely safe procedure; therefore, extreme care should always be given by the transplant teams to living donors to avoid any distressing morbidity or even, the less likely but more catastrophic, mortality.
Khalaf
H
H
Department of Liver Transplantation and Hepatobiliary-Pancreatic Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. hatem_khalaf@hotmail.com
Al-Sofayan
M
M
El-Sheikh
Y
Y
Al-Bahili
H
H
Al-Sagheir
M
M
Al-Sebayel
M
M
D000328:Adult; D002648:Child; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D007431:Intraoperative Complications / Q000145:classification / Q000453:epidemiology; D016031:Liver Transplantation / Q000706:statistics & numerical data; D019520:Living Donors; D012189:Retrospective Studies; D020858:Tissue and Organ Harvesting / Q000009:adverse effects; D016896:Treatment Outcome