title: Donor risk in adult-to-adult living donor liver transplantation: impact of left lobe graft.
abstract: BACKGROUND
  To ensure donor safety in adult-to-adult living donor liver transplantation, we established a selection criterion for donors in which left lobe (LL) was the first choice of graft.
  
  
  METHODS
  Two hundred six consecutive donors were retrospectively studied. Donors were divided into two groups according to graft type: LL graft (n=137) and right lobe (RL) graft (n=69).
  
  
  RESULTS
  Although mean intraoperative blood loss of LL was significantly increased compared with RL, mean peak postoperative total bilirubin levels and duration of hospital stay after surgery were significantly less for LL than RL (P<0.05). No donor died or suffered a life-threatening complication during the study period. The overall complication rate was 34.0%, including biliary complications in 5.3%. The number of biliary complications was four (2.9%) in LL and seven (10.1%) in RL (P<0.05). Logistic regression analysis revealed that only graft type (LL vs. RL) is significantly related to the occurrence of biliary complications (odds ratio 0.11; P=0.0012). The cumulative overall graft survival rates in the recipients with LL were not significantly different from that in the recipients with RL.
  
  
  CONCLUSIONS
  LL grafting should be considered favorably when selecting donors for adult-to-adult living donor liver transplantation.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. taketomi@surg2.med.kyushu-u.ac.jp
authors.forename: Akinobu
authors.initials: A
authors.lastname: Taketomi
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kayashima
authors.forename: Yuji
authors.initials: Y
authors.lastname: Soejima
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Yoshizumi
authors.forename: Hideaki
authors.initials: H
authors.lastname: Uchiyama
authors.forename: Toru
authors.initials: T
authors.lastname: Ikegami
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Noboru
authors.initials: N
authors.lastname: Harada
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Shimada
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000328:Adult; D001663:Bilirubin / Q000097:blood; D016063:Blood Loss, Surgical; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007564:Japan; D007902:Length of Stay; D008099:Liver / Q000033:anatomy & histology*; D019520:Living Donors; D008297:Male; D009679:Nuclear Family; D018579:Patient Selection; D012189:Retrospective Studies; D018570:Risk Assessment; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods*
chemical_list: D001663:Bilirubin