title: A learning curve for living donor liver transplantation.
abstract: BACKGROUND
  The number of living donor liver transplantations performed has increased rapidly in many Eastern transplant centres. However, the impact of the transplant centres' experience and learning on the transplant outcomes are not well established. Aim of the study was to evaluate the learning curve for living donor liver transplantation in our centre.
  
  
  METHODS
  Data from 156 recipients and 156 donors who underwent surgery were reviewed. Intraoperative data and postoperative outcomes of both donors and recipients were retrospectively analysed. Recipients and donors were divided into three groups that consisted of 52 consecutive cases each.
  
  
  RESULTS
  Surgical duration and intraoperative blood loss during donor surgery were decreased significantly between the earlier and the more recent cases (423±39 vs. 400±44 min and 959±523 vs. 731±278 mL, respectively; P<0.01). Rates of postoperative complications and functional changes were not statistically different amongst the three donor groups. Immediate complication rate of the first 52 recipients was higher than those of the second and third cohorts. Long-term survival rates of the three recipient groups were similar.
  
  
  CONCLUSIONS
  The learning curve greatly influenced immediate outcomes of recipients during the early transplant period. However, it had little influence on donor outcome; long-term outcome improvement of recipients did not depend on the accumulation of experience alone.
authors.affiliation: Division of Liver Transplantation, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Chuan
authors.initials: C
authors.lastname: Li
authors.forename: Kai
authors.initials: K
authors.lastname: Mi
authors.forename: Tian fu
authors.initials: Tf
authors.lastname: Wen
authors.forename: Lu nan
authors.initials: Ln
authors.lastname: Yan
authors.forename: Bo
authors.initials: B
authors.lastname: Li
authors.forename: Jia ying
authors.initials: Jy
authors.lastname: Yang
authors.forename: Ming qing
authors.initials: Mq
authors.lastname: Xu
authors.forename: Wen Tao
authors.initials: WT
authors.lastname: Wang
authors.forename: Yong gang
authors.initials: Yg
authors.lastname: Wei
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D059032:Learning Curve; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D013997:Time Factors; D009927:Tissue and Organ Procurement; D016896:Treatment Outcome