Safety of living donor in pediatric liver transplantation--analysis of 100 consecutive donors.
OBJECTIVE
The aim of this study was to evaluate safety of donors of liver fragments of different size and regeneration of the remaining liver.


METHODS
Between October 1999 and January 2007 liver segments II and III were harvested from 90 donors and segments II, III and IV from 10 donors. Liver volumetry by computed tomography (CT) and biochemical liver function tests were performed at baseline and 7 days, 30 days and 12 months after the operation.


RESULTS
CT-assisted volumetry correlated with mass of harvested graft (r=0.779; p<0.05). Twelve months after resection mean regeneration index was 138.64% +/- 23.98% in donors of segments II, III and IV and 109.93% +/- 18.36% in donors of segments II and III (p<0.02). Transient elevation of bilirubin and trans-aminases and decreased prothrombin index were observed in the early postoperative period. Twelve months after the operation mean levels of these parameters were within normal limits. No deaths and no severe complications were observed during the follow-up.


CONCLUSIONS
CT-assisted volumetry permits an adequate estimation of liver fragments intended for harvesting. Harvesting of II and III or II, III and IV segments does not compromise donor's safety. Liver regeneration is significantly greater after harvesting of II, III and IV segments than that of II and III segments.
Paluszkiewicz
Rafał
R
Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Poland. jrpalusz@excite.com
Zieniewicz
Krzysztof
K
Kalinowski
Piotr
P
Grzelak
Ireneusz
I
Hevelke
Piotr
P
Pacho
Ryszard
R
Lechowicz
Robert
R
Kaliciński
Piotr
P
Krawczyk
Marek
M
D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D002648:Child; D005260:Female; D006801:Humans; D008099:Liver / Q000033:anatomy & histology; D016031:Liver Transplantation / Q000379:methods; D019520:Living Donors; D008297:Male; D009929:Organ Size; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin