title: Adult living liver donors have excellent long-term medical outcomes: the University of Toronto liver transplant experience.
abstract: 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.
authors.affiliation: Liver Transplant Program, Multi-Organ Transplant Program, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada.
authors.forename: L
authors.initials: L
authors.lastname: Adcock
authors.forename: C
authors.initials: C
authors.lastname: Macleod
authors.forename: D
authors.initials: D
authors.lastname: Dubay
authors.forename: P D
authors.initials: PD
authors.lastname: Greig
authors.forename: M S
authors.initials: MS
authors.lastname: Cattral
authors.forename: I
authors.initials: I
authors.lastname: McGilvray
authors.forename: L
authors.initials: L
authors.lastname: Lilly
authors.forename: N
authors.initials: N
authors.lastname: Girgrah
authors.forename: E L
authors.initials: EL
authors.lastname: Renner
authors.forename: M
authors.initials: M
authors.lastname: Selzner
authors.forename: N
authors.initials: N
authors.lastname: Selzner
authors.forename: A
authors.initials: A
authors.lastname: Kashfi
authors.forename: R
authors.initials: R
authors.lastname: Smith
authors.forename: S
authors.initials: S
authors.lastname: Holtzman
authors.forename: S
authors.initials: S
authors.lastname: Abbey
authors.forename: D R
authors.initials: DR
authors.lastname: Grant
authors.forename: G A
authors.initials: GA
authors.lastname: Levy
authors.forename: G
authors.initials: G
authors.lastname: Therapondos
mesh_terms: 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