Revisiting the safety of living liver donors by reassessing 441 donor hepatectomies: is a larger hepatectomy complication-prone?
Donor safety is of paramount importance in performing living donor liver transplantation (LDLT). We retrospectively reviewed donor medical records to confirm whether larger donor hepatectomy is absolutely complication-prone. A total of 441 living donor hepatectomies were performed between October 1996 and July 2012 in our institute, which were divided into three eras (Era I, October 1996 to March 2004; Era II, April 2004 to March 2008; Era III, April 2008 to July 2012) and the incidences of postoperative complications were compared among the three types of hepatectomy-right hepatectomy (RH), left hepatectomy (LH) and left lateral segmentectomy (LLS). Although severe complications (Clavien's grade 3 or more) frequently occurred in RH in Eras I and II (15.4% and 10.7%, respectively), the incidence in Era III decreased to the comparable level observed in LH and LLS (5.4% in RH, 2.3% in LH and 5.3% in LLS). The incidence of postoperative complications did not relate to the type of hepatectomy selected in the latest era. Since most complications after hepatectomy were considered preventable, step-by-step meticulous surgical procedures are a prerequisite for further assuring donor safety irrespective of the type of hepatectomy selected.
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
H
H
Uchiyama
K
K
Shirabe
H
H
Nakagawara
T
T
Ikegami
T
T
Toshima
Y
Y
Soejima
T
T
Yoshizumi
Y-I
YI
Yamashita
N
N
Harimoto
T
T
Ikeda
Y
Y
Maehara
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D015994:Incidence; D008099:Liver / Q000601:surgery*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D012189:Retrospective Studies; D012449:Safety; D020858:Tissue and Organ Harvesting / Q000592:standards*
Clinical liver transplantation; donor risk; hepatic resection; living donor transplantation; postoperative complication