title: The Incidence of Posthepatectomy Liver Failure Defined by the International Study Group of Liver Surgery among Living Donors.
abstract: BACKGROUND
  Although several publications have reported donor morbidities, deterioration of liver function, which may cause posthepatectomy liver failure (PHLF), was not assessed specifically.
  
  
  METHODS
  The incidence of PHLF proposed by the International Study Group of Liver Surgery (ISGLS-PHLF) was analyzed among 257 living donors. ISGLS-PHLF was defined by an increased international normalized ratio and hyperbilirubinemia on or after postoperative day 5.
  
  
  RESULTS
  ISGLS-PHLF was identified in 21 donors (8%), of which 18 (85.7%) were grade A, 2 (9.5%) were grade B, and 1 (4.8%) was grade C. The average hospital stay without ISGLS-PHLF was 15 ± 1 days, which extended along with increasing grades (p = 0.03). In univariate analysis, right hepatectomy was significantly associated with the incidence of ISGLS-PHLF (p = 0.02), and right hepatectomy (p = 0.002) and operation time (p = 0.01) in multivariate analysis. Of 176 right lobe donors, 19 (10.8%) developed ISGLS-PHLF, of which 16 (84.2%) were grade A, 2 (10.5%) were grade B, and 1 (5.3%) was grade C. Operation time was significantly associated with the incidence of ISGLS-PHLF in univariate (p = 0.002) and multivariate (p = 0.003) analyses.
  
  
  CONCLUSIONS
  Right lobe donation surgery is associated with a higher incidence of ISGLS-PHLF.
authors.affiliation: Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe City, Hyogo, Japan. kkuramit@med.kobe-u.ac.jp.
authors.forename: Kaori
authors.initials: K
authors.lastname: Kuramitsu
authors.affiliation: Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe City, Hyogo, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Fukumoto
authors.affiliation: Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe City, Hyogo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Fukushima
authors.affiliation: Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Sho
authors.initials: S
authors.lastname: Okimoto
authors.affiliation: Department of Surgery, National Hospital Organization Kobe Medical Center, Kobe, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Iwasaki
authors.affiliation: Department of Surgery, Division of Gastroenterological Surgery, Hyogo Cancer Center, Hyogo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tominaga
authors.affiliation: Department of Diagnostic Pathology, Graduate School of Medicine, Kobe University, Kobe, Japan.
authors.forename: Yoh
authors.initials: Y
authors.lastname: Zen
authors.affiliation: Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohdan
authors.affiliation: Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe City, Hyogo, Japan.
authors.forename: Yonson
authors.initials: Y
authors.lastname: Ku
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D006932:Hyperbilirubinemia / Q000097:blood; D015994:Incidence; D019934:International Normalized Ratio; D007902:Length of Stay; D017093:Liver Failure / Q000097:blood / Q000453:epidemiology* / Q000209:etiology*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012307:Risk Factors; D055815:Young Adult
keywords: ISGLS; Liver transplantation; Living donors; PHLF