title: Risk Factors Associated with Increased Morbidity in Living Liver Donation.
abstract: Living donor liver donation (LDLD) is an alternative to cadaveric liver donation. We aimed at identifying risk factors and developing a score for prediction of postoperative complications (POCs) after LDLD in donors. This is a retrospective cohort study in 688 donors between June 1995 and February 2014 at Hospital Sírio-Libanês and A.C. Camargo Cancer Center, in São Paulo, Brazil. Primary outcome was POC graded ≥III according to the Clavien-Dindo classification. Left lateral segment (LLS), left lobe (LL), and right lobe resections (RL) were conducted in 492 (71.4%), 109 (15.8%), and 87 (12.6%) donors, respectively. In total, 43 (6.2%) developed POCs, which were more common after RL than LLS and LL (14/87 (16.1%) versus 23/492 (4.5%) and 6/109 (5.5%), resp., p < 0.001). Multivariate analysis showed that RL resection (OR: 2.81, 95% CI: 1.32 to 3.01; p = 0.008), smoking status (OR: 3.2, 95% CI: 1.35 to 7.56; p = 0.012), and blood transfusion (OR: 3.15, 95% CI: 1.45 to 6.84; p = 0.004) were independently associated with POCs. RL resection, intraoperative blood transfusion, and smoking were associated with increased risk for POCs in donors.
authors.affiliation: Hepatology and Liver Transplantation, Hospital Sírio-Libanês, Rua Barata Ribeiro 414, cj 65, 01308-000 Bela Vista, SP, Brazil; Hepatology and Liver Transplantation, A.C. Camargo Cancer Center, São Paulo, SP, Brazil.
authors.forename: Helry L
authors.initials: HL
authors.lastname: Candido
authors.affiliation: Hepatology and Liver Transplantation, Hospital Sírio-Libanês, Rua Barata Ribeiro 414, cj 65, 01308-000 Bela Vista, SP, Brazil; Hepatology and Liver Transplantation, A.C. Camargo Cancer Center, São Paulo, SP, Brazil.
authors.forename: Eduardo A
authors.initials: EA
authors.lastname: da Fonseca
authors.affiliation: Hepatology and Liver Transplantation, Hospital Sírio-Libanês, Rua Barata Ribeiro 414, cj 65, 01308-000 Bela Vista, SP, Brazil; Hepatology and Liver Transplantation, A.C. Camargo Cancer Center, São Paulo, SP, Brazil.
authors.forename: Flávia H
authors.initials: FH
authors.lastname: Feier
authors.affiliation: Hepatology and Liver Transplantation, Hospital Sírio-Libanês, Rua Barata Ribeiro 414, cj 65, 01308-000 Bela Vista, SP, Brazil; Hepatology and Liver Transplantation, A.C. Camargo Cancer Center, São Paulo, SP, Brazil.
authors.forename: Renata
authors.initials: R
authors.lastname: Pugliese
authors.affiliation: Hepatology and Liver Transplantation, Hospital Sírio-Libanês, Rua Barata Ribeiro 414, cj 65, 01308-000 Bela Vista, SP, Brazil; Hepatology and Liver Transplantation, A.C. Camargo Cancer Center, São Paulo, SP, Brazil.
authors.forename: Marcel A
authors.initials: MA
authors.lastname: Benavides
authors.affiliation: Department of Anesthesiology, Hospital Sírio-Libanês, Rua Barata Ribeiro 414, cj 65, 01308-000 Bela Vista, SP, Brazil.
authors.forename: Enis D
authors.initials: ED
authors.lastname: Silva
authors.affiliation: Department of Anesthesiology, A.C. Camargo Cancer Center, São Paulo, Brazil.
authors.forename: Karina
authors.initials: K
authors.lastname: Gordon
authors.affiliation: Department of Anesthesiology and Intensive Care Therapy, Pulmonary Engineering Group, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
authors.forename: Marcelo Gama
authors.initials: MG
authors.lastname: de Abreu
authors.affiliation: Department of Anesthesiology, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Canet
authors.affiliation: Hepatology and Liver Transplantation, Hospital Sírio-Libanês, Rua Barata Ribeiro 414, cj 65, 01308-000 Bela Vista, SP, Brazil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Chapchap
authors.affiliation: Hepatology and Liver Transplantation, Hospital Sírio-Libanês, Rua Barata Ribeiro 414, cj 65, 01308-000 Bela Vista, SP, Brazil; Hepatology and Liver Transplantation, A.C. Camargo Cancer Center, São Paulo, SP, Brazil.
authors.forename: Joao Seda
authors.initials: JS
authors.lastname: Neto