title: Remnant left liver size and recovery of living right liver donors.
abstract: OBJECTIVE
  Living donor liver transplantation is a realistic life-saving treatment in regions where deceased donor organs are scarce. The minimum remnant left liver volume (RLLV) requirement for donor right hepatectomy (DRH) varies in different programs of living donor liver transplantation. The present study aimed to determine how significant the RLLV is in the recovery of right liver donors.
  
  
  METHODS
  A total of 349 consecutive donors who underwent DRH including the middle hepatic vein were divided into nine groups according to the percentage of the RLLV. The peak and recovery of the serum bilirubin level and prothrombin time (PT) in the 1st week after operation and postoperative complications were studied.
  
  
  RESULTS
  The median RLLV was 35.5 (27-49.5) %. Postoperative peak serum bilirubin was highest [74 (25-133) μmol/L] in the group with RLLVs <30 %. This group also had the highest peak PT [18.9 (15.4-24.4) s], although results were similar between groups. Total bilirubin peaked on postoperative days 1-2 in groups with RLLVs ≥35 %. In groups with RLLVs <35 %, total bilirubin peaked on day 3. PT took 1-2 days to peak and nearly approached preoperative values on day 7 in all groups. Complication rates ranged from 0 to 75 %. The rates of complications of Clavien-Dindo grade 3 or above ranged from 0 to 3.8 %. Postoperative peak bilirubin was associated with severe complications (p = 0.031). Age, postoperative peak PT, and RLLV were independent risk factors for prolonged hospital stay.
  
  
  CONCLUSIONS
  There was a demonstrable trend of slower recovery of liver function in donors with smaller RLLVs.
authors.affiliation: Department of Surgery, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.
authors.forename: Yuen Ki
authors.initials: YK
authors.lastname: Fong
authors.affiliation: Department of Surgery, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China. seechingchan@gmail.com.|State Key Laboratory for Liver Research, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China. seechingchan@gmail.com.
authors.forename: See Ching
authors.initials: SC
authors.lastname: Chan
authors.affiliation: Department of Surgery, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.
authors.forename: Tan To
authors.initials: TT
authors.lastname: Cheung
authors.affiliation: Department of Surgery, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.
authors.forename: Wing Chiu
authors.initials: WC
authors.lastname: Dai
authors.affiliation: Department of Surgery, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.
authors.forename: Kenneth S H
authors.initials: KS
authors.lastname: Chok
authors.affiliation: Department of Surgery, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.
authors.forename: Albert C Y
authors.initials: AC
authors.lastname: Chan
authors.affiliation: Department of Surgery, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.
authors.forename: William W
authors.initials: WW
authors.lastname: Sharr
authors.affiliation: Department of Surgery, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.|State Key Laboratory for Liver Research, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.
authors.forename: Chung Mau
authors.initials: CM
authors.lastname: Lo
keywords: Living donor liver transplantation; Remnant; Size