title: Short- and long-term donor morbidity in right lobe living donor liver transplantation: 91 consecutive cases in a European Center.
abstract: The lack of use of a common grading system in reporting morbidity impedes estimation of the true risk to a right lobe living donor (RLLD). We report outcomes in 91 consecutive RLLD's using the validated 5-tier Clavien grading and a quality of life (QOL) questionnaire. The median follow-up was 79 months. The donors were predominantly female (66%), 22 (24%) received autologous blood transfusions. Fifty-three complications occurred in 43 donors (47% morbidity), 19 (37%) were ≥ Grade III, biliary fistula (14%) was the most common. There was no donor mortality. Two intraoperative complications could not be graded and two disfiguring complications in female donors were graded as minor. Two subgroups (first 46 vs. later 45 donors) were compared to study the presence if any, of a learning curve. The later 45 donors had lesser autologous transfusions, lesser rehospitalization and no reoperation and a reduction in the proportion of ≥ Grade III (major) complications (24% vs. 50%; p = 0.06). In the long term, donors expressed an overall sense of well being, but some sequelae of surgery do restrain their current lifestyle. Our results warn against lackadaisical vigilance once RLLD hepatectomy becomes routine.
authors.affiliation: AP-HP Hôpital Paul Brousse, Centre Hépato-Biliaire, Villejuif, France. daniel.azoulay@pbr.aphp.fr
authors.forename: D
authors.initials: D
authors.lastname: Azoulay
authors.forename: P
authors.initials: P
authors.lastname: Bhangui
authors.forename: P
authors.initials: P
authors.lastname: Andreani
authors.forename: C
authors.initials: C
authors.lastname: Salloum
authors.forename: V
authors.initials: V
authors.lastname: Karam
authors.forename: E
authors.initials: E
authors.lastname: Hoti
authors.forename: G
authors.initials: G
authors.lastname: Pascal
authors.forename: R
authors.initials: R
authors.lastname: Adam
authors.forename: D
authors.initials: D
authors.lastname: Samuel
authors.forename: Ph
authors.initials: P
authors.lastname: Ichai
authors.forename: F
authors.initials: F
authors.lastname: Saliba
authors.forename: D
authors.initials: D
authors.lastname: Castaing
mesh_terms: D000328:Adult; D005260:Female; D005602:France / Q000453:epidemiology; D006498:Hepatectomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011788:Quality of Life; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*