Perioperative complications after live-donor hepatectomy.
Current studies of complications following donor hepatectomy may not be generalizable to all hospitals performing this procedure. To address this, live liver donors were identified in the Nationwide Inpatient Sample (2000-2008). Complications after donor hepatectomy were categorized using International Classification of Diseases, Ninth Revision codes and risk factors for complications were tested using logistic regression. Negative binomial regression models were used to estimate the increase in length of stay and hospital charge associated with complications. Among 555 donors (representing 2783 donors nationwide), 23% had 1 or more complications and 5% had a major complication. The most common complications were ileus (27%) and atelectasis (26%). No patient or hospital factors were associated with complications. Having any complication was associated with increased length of stay (incidence rate ratio, 1.36; 95% CI, 1.16-1.58; P < .001) and hospital charge (incidence rate ratio, 1.25; 95% CI, 1.09-1.44; P = .002). Approximately 25% of liver donors have complications immediately postoperatively but most are minor, lending support to current practices in live liver donation and donor selection.
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland2Department of Surgery, Georgetown University School of Medicine, Washington DC.
Erin C
EC
Hall
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Brian J
BJ
Boyarsky
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Neha A
NA
Deshpande
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Jacqueline M
JM
Garonzik-Wang
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Jonathan C
JC
Berger
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Nabil N
NN
Dagher
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland3Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Dorry L
DL
Segev
D000293:Adolescent; D000328:Adult; D016542:Chief Executive Officers, Hospital; D046148:Donor Selection; D005260:Female; D006498:Hepatectomy; D006801:Humans; D045823:Ileus / Q000453:epidemiology; D007431:Intraoperative Complications / Q000453:epidemiology*; D007902:Length of Stay / Q000706:statistics & numerical data; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D011183:Postoperative Complications / Q000453:epidemiology*; D001261:Pulmonary Atelectasis / Q000453:epidemiology; D055815:Young Adult