title: Safety of Live Liver Donation by Individuals With G6PD Deficiency: Initial Results and Comparative Study.
abstract: BACKGROUND
  G6PD deficiency (G6PDd) is the commonest genetic enzyme defect in the world. However, baring a single case report, there is no published literature regarding the safety of donor hepatectomy in G6PDd individuals.
  
  
  METHODS
  Potential donors with World Health Organization class III or class IV G6PDd without evidence of hemolysis were evaluated for donation, if there was no other suitable donor. Postoperatively, donors were closely monitored for hemolysis and medications, which can induce hemolysis, were avoided. Outcomes of our first 14 G6PDd donors are presented. Postoperative course of these donors was also compared with a matched cohort of 30 non-G6PDd donors.
  
  
  RESULTS
  There were 9 left lateral segment, 2 left lobe, and 3 right lobe donors. Two G6PDd donors had biochemical evidence of postoperative hemolysis not needing any specific treatment. Postoperative liver function tests, intensive care unit stay, hospital stay, and morbidity (greater than Clavien II) were similar in the G6PDd and non-G6PDd donor cohorts. Donors in the G6PDd group had lower trough hemoglobin in postoperative period (P = 0.006), greater drop in postoperative hemoglobin (P = 0.007), and a higher need for postoperative blood transfusion (4/14 vs 2/30, P = 0.071).
  
  
  CONCLUSIONS
  This is the first case series reporting the safety of liver resection in G6PDd individuals. Hepatectomy in G6PD-deficient donors is associated with a greater drop in postoperative hemoglobin and a marginally increased need for postoperative transfusion. Use of these donors can be considered with caution, and it should not be an absolute contraindication for live liver donation.
authors.affiliation: 1 Institute of Liver Disease and Transplantation, Global Healthy City, Chennai, India. National Foundation for Liver Research, Chennai, India.
authors.forename: Mettu S
authors.initials: MS
authors.lastname: Reddy
authors.forename: Manoj
authors.initials: M
authors.lastname: Shrivastav
authors.forename: Ilankumaran
authors.initials: I
authors.lastname: Kaliamoorthy
authors.forename: Venugopal
authors.initials: V
authors.lastname: Kota
authors.forename: Abderrhaim
authors.initials: A
authors.lastname: Dabora
authors.forename: Sanjay
authors.initials: S
authors.lastname: Govil
authors.forename: Mohamed
authors.initials: M
authors.lastname: Rela
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001803:Blood Transfusion; D016022:Case-Control Studies; D046148:Donor Selection; D005260:Female; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000150:complications* / Q000175:diagnosis / Q000201:enzymology / Q000235:genetics; D006454:Hemoglobins / Q000378:metabolism; D006461:Hemolysis; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D011183:Postoperative Complications / Q000097:blood / Q000628:therapy; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006454:Hemoglobins