title: Intraoperative factors associated with delayed recovery of liver function after hepatectomy: analysis of 1969 living donors.
abstract: BACKGROUND
  The safety of healthy living donors who are undergoing hepatic resection is a primary concern. We aimed to identify intraoperative anaesthetic and surgical factors associated with delayed recovery of liver function after hepatectomy in living donors.
  
  
  METHODS
  We retrospectively analysed 1969 living donors who underwent hepatectomy for living donor liver transplantation. Delayed recovery of hepatic function was defined by increases in international normalised ratio of prothrombin time and concomitant hyperbilirubinaemia on or after post-operative day 5. Univariate and multivariate logistic regression analyses were performed to determine the factors associated with delayed recovery of hepatic function after living donor hepatectomy.
  
  
  RESULTS
  Delayed recovery of liver function after donor hepatectomy was observed in 213 (10.8%) donors. Univariate logistic regression analysis showed that sevoflurane anaesthesia, synthetic colloid, donor age, body mass index, fatty change and remnant liver volume were significant factors for prediction of delayed recovery of hepatic function. Multivariate logistic regression analysis showed that independent factors significantly associated with delayed recovery of liver function after donor hepatectomy were sevoflurane anaesthesia (odds ratio = 3.514, P < 0.001), synthetic colloid (odds ratio = 1.045, P = 0.033), donor age (odds ratio = 0.970, P = 0.003), female gender (odds ratio = 1.512, P = 0.014) and remnant liver volume (odds ratio = 0.963, P < 0.001).
  
  
  CONCLUSIONS
  Anaesthesia with sevoflurane was an independent factor in predicting delayed recovery of hepatic function after donor hepatectomy. Although synthetic colloid may be associated with delayed recovery of hepatic function after donor hepatectomy, further study is required. These results can provide useful information on perioperative management of living liver donors.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: S-S
authors.initials: SS
authors.lastname: Choi
authors.affiliation: Department of Occupational and Environmental Medicine, Konkuk University Chungju Hospital, Chungju, Korea.|Department of Occupational and Environmental Health, Graduate School of Public Health, Seoul National University, Seoul, Korea.
authors.forename: S-S
authors.initials: SS
authors.lastname: Cho
authors.affiliation: Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: T-Y
authors.initials: TY
authors.lastname: Ha
authors.affiliation: Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: S
authors.initials: S
authors.lastname: Hwang
authors.affiliation: Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: S-G
authors.initials: SG
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Y-K
authors.initials: YK
authors.lastname: Kim
mesh_terms: D000328:Adult; D003102:Colloids / Q000008:administration & dosage; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000503:physiopathology*; D016031:Liver Transplantation; D019520:Living Donors; D016015:Logistic Models; D008297:Male; D008738:Methyl Ethers / Q000494:pharmacology; D016343:Monitoring, Intraoperative; D020127:Recovery of Function; D012189:Retrospective Studies; D000077149:Sevoflurane
chemical_list: D003102:Colloids; D008738:Methyl Ethers; D000077149:Sevoflurane