Comparison of right lobe donor hepatectomy with elective right hepatectomy for other causes in New York.
BACKGROUND
Right lobe donor hepatectomy (RLDH) is a potential source of liver allografts given the ongoing shortage of deceased donor organs available. Since there is no live donor registry in the United States, a population-based, unsolicited state-wide analysis has yet to be reported.


METHODS
The New York (NY) State Inpatient Database was used to query 1,524 elective liver lobectomies performed from 2001 to 2006. RLDH were identified in this cohort (n = 195; 13%). Most common indications for elective right lobe hepatectomy (ERH) were metastatic colon cancer (50%) and hepatocellular carcinoma (HCC) (34%). Primary outcomes were mortality, perioperative resources and major postoperative complications.


RESULTS
After a dramatic drop in 2002, there was a slow increase in RLDH from 2003 to 2006 in New York. Donors were younger (median age 36 vs. 60 years, P < 0.0001) and healthier (75% with no comorbidities vs. 18%, P < 0.0001) than patients undergoing ERH for other causes. Median length of hospital stay was 7 days in both groups. Donors were less likely to require blood transfusion (22.6 vs. 62.8%, P < 0.0001) and received less blood (mean 0.10 units vs. 2.4 units). Major post-operative complications based on the Clavien classification occurred in only 2.6% of donor cases compared to 13.8% in non-donors (P < 0.0001). There was one RLDH in-hospital mortality (0.5%) in New York compared to 4.3% after ERH (P = 0.003).


CONCLUSIONS
This study represents one of the first unsolicited regional analyses of donor morbidity and resource utilization for RLDH and further emphasizes the need and utility of a live donor registry.
Department of Surgery, Solid Organ Transplantation, Surgical Outcomes Analysis and Research, University of Massachusetts Medical School, 55 Lake Avenue North, S6-432, Worcester, MA 01655, USA.
Andrew T
AT
Burr
Nicholas G
NG
Csikesz
Earl
E
Gonzales
Jennifer F
JF
Tseng
Reza F
RF
Saidi
Adel
A
Bozorgzadeh
Shimul A
SA
Shah
D000293:Adolescent; D000328:Adult; D000368:Aged; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D016031:Liver Transplantation; D019520:Living Donors; D008875:Middle Aged; D009518:New York; D011183:Postoperative Complications; D012189:Retrospective Studies; D055815:Young Adult