Adult living liver donors have excellent long-term medical outcomes: the University of Toronto liver transplant experience.
Right lobe living donor liver transplantation is an effective treatment for selected individuals with end-stage liver disease. Although 1 year donor morbidity and mortality have been reported, little is known about outcomes beyond 1 year. Our objective was to analyze the outcomes of the first 202 consecutive donors performed at our center with a minimum follow-up of 12 months (range 12-96 months). All physical complications were prospectively recorded and categorized according to the modified Clavien classification system. Donors were seen by a dedicated family physician at 2 weeks, 1, 3 and 12 months postoperatively and yearly thereafter. The cohort included 108 males and 94 females (mean age 37.3 +/- 11.5 years). Donor survival was 100%. A total of 39.6% of donors experienced a medical complication during the first year after surgery (21 Grade 1, 27 Grade 2, 32 Grade 3). After 1 year, three donors experienced a medical complication (1 Grade 1, 1 Grade 2, 1 Grade 3). All donors returned to predonation employment or studies although four donors (2%) experienced a psychiatric complication. This prospective study suggests that living liver donation can be performed safely without any serious late medical complications and suggests that long-term follow-up may contribute to favorable donor outcomes.
Adcock
L
L
Liver Transplant Program, Multi-Organ Transplant Program, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada.
Macleod
C
C
Dubay
D
D
Greig
P D
PD
Cattral
M S
MS
McGilvray
I
I
Lilly
L
L
Girgrah
N
N
Renner
E L
EL
Selzner
M
M
Selzner
N
N
Kashfi
A
A
Smith
R
R
Holtzman
S
S
Abbey
S
S
Grant
D R
DR
Levy
G A
GA
Therapondos
G
G
D000328:Adult; D005260:Female; D006801:Humans; D008099:Liver / Q000601:surgery; D017093:Liver Failure / Q000601:surgery; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D009017:Morbidity; D011446:Prospective Studies; D014019:Tissue Donors; D016896:Treatment Outcome; D014495:Universities