title: Complications and mortality after adult to adult living donor liver transplantation: A retrospective cohort study.
abstract: OBJECTIVE
  Living donor liver transplantation (LDLT) is widely performed for patients to resolve the critical shortage of organs from cadavers. Despite rapid implementation of the procedure, both complications and mortality of LDLT are annoying problems. The aim of this study was to analyze complications and mortality of patients after adult to adult LDLT (A-ALDLT) in a single center.
  
  
  METHODS
  Between April 2003 and November 2013, 167 (A-ALDLT) recipients in National Liver Institute, Egypt were included. We retrospectively analyzed complications and mortality in them.
  
  
  RESULTS
  The overall incidence of complications was 86.2% (n = 144) and classified as biliary 43.7% (n = 73), vascular 21.6% (n = 36), Small for size syndrome (SFSS) 12.6% (n = 21), Gastrointestinal tract (GIT) 19.8% (n = 33), wound 12.6% (n = 21), chest 19.8% (n = 33), neurological 26.3% (n = 44), renal 21% (n = 35), intra abdominal collection 21.6% (n = 36), recurrent hepatitis C virus (HCV) 16.8% (n = 28), recurrent hepatocellular carcinoma (HCC) 2.4% (n = 4), acute rejection 19.2% (n = 32). 65 (45.1%) of 144 complicated patients died, while 10 (43.5%) of 23 non complicated died. The incidence of whole, in hospital and late mortalities were 44.9%, 28.7% and 16.2% respectively.
  
  
  CONCLUSIONS
  Mortality was higher among complicated cases where vascular complications and SFSS had significant effect on it so prevention and treatment of them is required for improving outcome.
authors.affiliation: Hepatobiliary Surgery Department, National Liver Institute, Menoufiya University, Shibin El-Kom, Menoufiya, Egypt.
authors.forename: Emad Hamdy
authors.initials: EH
authors.lastname: Gad
authors.affiliation: Hepatology Department, National Liver Institute, Menoufiya University, Shibin El-Kom, Menoufiya, Egypt.
authors.forename: Ayman
authors.initials: A
authors.lastname: Alsebaey
authors.affiliation: Anesthesia Department, National Liver Institute, Menoufiya University, Shibin El-Kom, Menoufiya, Egypt.
authors.forename: Maha
authors.initials: M
authors.lastname: Lotfy
authors.affiliation: Hepatology Department, National Liver Institute, Menoufiya University, Shibin El-Kom, Menoufiya, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Eltabbakh
authors.affiliation: Hepatobiliary Surgery Department, National Liver Institute, Menoufiya University, Shibin El-Kom, Menoufiya, Egypt.
authors.forename: Ahmed Alshawadfy
authors.initials: AA
authors.lastname: Sherif
keywords: Complications after LDLT; Living donor liver transplantation (LDLT); Mortality after LDLT; Outcome post LDLT