Three-quarters of right liver donors experienced postoperative complications.
A donor right hepatectomy (RH) is associated with a higher rate of morbidity than a left hepatectomy. Therefore, the precise morbidity should be known to improve the success of donor RH implementation. However, the rate of complication varies according to the individual definition of morbidity. This study prospectively analyzed the outcomes of 83 consecutive living donor RHs between January 2002 and July 2004 using a standardized classification of the severity of complications. The morbidity was classified using the modified Clavien system: grade I for minor complications; grade II for potentially life-threatening complications requiring pharmacological treatment; grade III for complications requiring invasive intervention; grade IV for complications causing organ dysfunction requiring intensive care unit management; and grade V complications resulting in the death of the patient. The donors were followed-up regularly for at least 12 months. No donor death or relaparotomy was noted. Overall, 65 out of 83 donors (78.3%) experienced postoperative complications: grades I, II, III, IV, and V complications in 64 (77.1%), 11 (13.3%), 1 (1.2%), 0, and 0 patients, respectively. The most common grade I complications were hyperbilirubinemia (n = 31) and pleural effusion (n = 31), and bile leakage in grade II (n = 7). The bilirubin and alanine aminotransferase levels were normal in 92.7% of donors at the 1-year follow-up. In conclusion, although most of these adverse events were minor and self-limited, 78% of right liver donors still experienced morbidity. Therefore, continuous standardized reporting of the donor morbidity as well as meticulous surgery and intensive care are essential for the success of donor RH implementation.
Yi
Nam-Joon
NJ
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Suh
Kyung-Suk
KS
Cho
Jai Young
JY
Lee
Hae Won
HW
Cho
Eung-Ho
EH
Yang
Sung Hoon
SH
Cho
Yong Beom
YB
Lee
Kuhn Uk
KU
D000328:Adult; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008111:Liver Function Tests; D016031:Liver Transplantation; D019520:Living Donors / Q000706:statistics & numerical data*; D008297:Male; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology*; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed