title: Incidence and risk factors of intraoperative adverse events during donor lobectomy for living-donor liver transplantation: a retrospective analysis.
abstract: OBJECTIVE
  To evaluate the frequency, type, and predictors of intraoperative adverse events during donor hepatectomy for living-donor liver transplant.
  
  
  METHODS
  Retrospective analyses of the data from 182 consecutive living-donor liver transplant donors between May 2002 and September 2008.
  
  
  RESULTS
  Ninety-one patients (50%) had at least 1 intraoperative adverse event including hypothermia (39%), hypotension (26%), need for transfusions (17%), and hypertension (7%). Patients with an adverse event were older (P = .001), had a larger graft weight (P = .023), more frequently underwent a right hepatectomy (P = .019), and were more frequently classified as American Society of Anesthesiologists physical status class II (P = .027) than those who did not have these adverse events. Logistic regression analysis revealed that only age (95% confidence interval 1.018-1.099; P = .001) was a risk factor for intraoperative adverse events. Patients with these adverse events more frequently required admission to the intensive care unit and were hospitalized longer postoperatively. A before and after analysis showed that after introduction of in-line fluid warmers and more frequent use of acute normovolemic hemodilution, the frequency of intraoperative adverse events was significantly lower (80% vs 29%; P < .001).
  
  
  CONCLUSIONS
  Intraoperative adverse events such as hypothermia and hypotension were common in living-donor liver transplant donors, and older age was associated with an increased risk of these adverse events. However, the effect of these adverse events on postoperative recovery is not clear.
authors.affiliation: Department of Anesthesiology, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Coskun
authors.initials: C
authors.lastname: Araz
authors.forename: Arash
authors.initials: A
authors.lastname: Pirat
authors.forename: Aytekin
authors.initials: A
authors.lastname: Unlukaplan
authors.forename: Adnan
authors.initials: A
authors.lastname: Torgay
authors.forename: Hamdi
authors.initials: H
authors.lastname: Karakayali
authors.forename: Gulnaz
authors.initials: G
authors.lastname: Arslan
authors.forename: Gokhan
authors.initials: G
authors.lastname: Moray
authors.forename: Mehmet
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000328:Adult; D000368:Aged; D001803:Blood Transfusion / Q000706:statistics & numerical data; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D007022:Hypotension / Q000453:epidemiology; D007035:Hypothermia / Q000453:epidemiology; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology*; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data*; D019520:Living Donors / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult