title: Selection and outcome of the potential live liver donor.
abstract: OBJECTIVE
  A thorough donor evaluation in the living donation process is mandatory to ensure a safe outcome in an otherwise healthy individual. The aim of the current study was to evaluate the reasons for not proceeding to donation and the outcome of live liver donors.
  
  
  METHODS
  A prospective study of potential donors who underwent evaluation and proceeded to surgery from 1 April 2012 to 31 January 2015 was conducted. The process of donor selection, its outcome and peri-operative complications were recorded.
  
  
  RESULTS
  A total of 460 donors were evaluated in a stepwise manner for 367 potential recipients. Of the 321 (69.7 %) donors not proceeding to donation, the reasons were donor-related in 63.6 % and recipient-related in the rest. Common donor-related reasons were: donor reluctance (23.5 %), negative liver attenuation index (16.2 %), anatomic variations (10.3 %), inadequate remnant liver volume (9.8 %), unacceptable liver biopsy (8.8 %), and inadequate graft volume (5.4 %). A majority of donors (82.8 %) were turned down early in the (steps 1 and 2) evaluation process. Recipient death was the most common recipient-related reason [n = 51 (43.6 %)] for not proceeding to donation. There was no donor mortality. The overall complication rate was 19.8 % and major complication rate (grade 3 or higher) was 4.4 %.
  
  
  CONCLUSIONS
  A stringent stepwise donor evaluation process leads to early recognition of unsuitable donors and a low complication rate.
authors.affiliation: Department of Liver Transplantation and Hepato Pancreatico Biliary Surgery, Institute of Liver and Biliary Sciences, D1, Vasant Kunj, New Delhi, 110070, India. viniyendra@yahoo.co.uk.
authors.forename: Viniyendra
authors.initials: V
authors.lastname: Pamecha
authors.affiliation: Department of Liver Transplantation and Hepato Pancreatico Biliary Surgery, Institute of Liver and Biliary Sciences, D1, Vasant Kunj, New Delhi, 110070, India.
authors.forename: Shyam Sunder
authors.initials: SS
authors.lastname: Mahansaria
authors.affiliation: Department of Liver Transplantation and Hepato Pancreatico Biliary Surgery, Institute of Liver and Biliary Sciences, D1, Vasant Kunj, New Delhi, 110070, India.
authors.forename: Kishore G S
authors.initials: KG
authors.lastname: Bharathy
authors.affiliation: Department of Liver Transplantation and Hepato Pancreatico Biliary Surgery, Institute of Liver and Biliary Sciences, D1, Vasant Kunj, New Delhi, 110070, India.
authors.forename: Senthil
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Department of Liver Transplantation and Hepato Pancreatico Biliary Surgery, Institute of Liver and Biliary Sciences, D1, Vasant Kunj, New Delhi, 110070, India.
authors.forename: Shridhar Vasantrao
authors.initials: SV
authors.lastname: Sasturkar
authors.affiliation: Department of Liver Transplantation and Hepato Pancreatico Biliary Surgery, Institute of Liver and Biliary Sciences, D1, Vasant Kunj, New Delhi, 110070, India.
authors.forename: Piyush Kumar
authors.initials: PK
authors.lastname: Sinha
authors.affiliation: Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
authors.forename: Shiv Kumar
authors.initials: SK
authors.lastname: Sarin
mesh_terms: D000328:Adult; D046148:Donor Selection / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007194:India; D016031:Liver Transplantation; D019520:Living Donors / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D009927:Tissue and Organ Procurement / Q000592:standards / Q000706:statistics & numerical data; D066027:Transplant Recipients; D055815:Young Adult
keywords: Donor reluctance; Future liver remnant; Graft recipient weight ratio; Living donor liver transplantation; Morbidity