title: Impact of intra-operative cholangiography and parenchymal resection to donor liver function in living donor liver transplantation.
abstract: BACKGROUND
  Living donor liver transplantation (LDLT) has been widely accepted over the past decade, and hepatic dysfunction often occurs in the donor in the early stage after liver donation. The present study aimed to evaluate the effect of intra-operative cholangiography (IOC) and parenchymal resection on liver function of donors in LDLT, and to assess the role of IOC in influencing the biliary complications and improving the overall outcome.
  
  
  METHODS
  Data from 40 patients who had donated their right lobes for LDLT were analyzed. Total bilirubin (TB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and gamma-glutamyl transpeptidase (GGT) at different time points were compared, and the follow-up data and the biliary complications were also analyzed.
  
  
  RESULTS
  The ALT and AST values were significantly increased after IOC (P<0.001) and parenchymal resection (P<0.001). However, the median values of TB, ALP and GGT were not significantly influenced by IOC (P>0.05) or parenchymal resection (P>0.05). The biochemical changes caused by IOC or parenchymal resection were not correlated with the degree of post-operative liver injury or the recovery of liver function. The liver functions of the donors after operation were stable, and none of the donors suffered from biliary stenosis or leakage during the follow-up.
  
  
  CONCLUSIONS
  IOC and parenchymal resection may induce a transient increase in liver enzymes of donors in LDLT, but do not affect the recovery of liver function after operation. Moreover, the routine IOC is helpful to clarify the division line of the hepatic duct, thus reducing the biliary complication rate.
authors.affiliation: Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Key Lab of Combined Multi-Organ Transplantation, Ministry of Public Health, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China. zyzss@zju.edu.cn.
authors.forename: Feng
authors.initials: F
authors.lastname: Gao
authors.forename: Xiao
authors.initials: X
authors.lastname: Xu
authors.forename: Yang-Bo
authors.initials: YB
authors.lastname: Zhu
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wei
authors.forename: Bin
authors.initials: B
authors.lastname: Zhou
authors.forename: Xiao-Yong
authors.initials: XY
authors.lastname: Shen
authors.forename: Qi
authors.initials: Q
authors.lastname: Ling
authors.forename: Hai-Yang
authors.initials: HY
authors.lastname: Xie
authors.forename: Jian
authors.initials: J
authors.lastname: Wu
authors.forename: Wei-Lin
authors.initials: WL
authors.lastname: Wang
authors.forename: Shu-Sen
authors.initials: SS
authors.lastname: Zheng
mesh_terms: D000328:Adult; D000368:Aged; D001660:Biliary Tract Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D015415:Biomarkers / Q000097:blood; D002758:Cholangiography; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007430:Intraoperative Care; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers