title: Longterm clinical and radiological follow-up of living liver donors.
abstract: Although short-term risks of living donor hepatectomy have been well defined, little is known about the longterm impact. We aimed to perform a systematic follow-up to screen for unanticipated health consequences of liver donation. All donors who were more than 1 year from donation were invited for a systematic evaluation including physical and laboratory assessment, quality of life questionnaire, and magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP). Those unable to return were offered the questionnaire and laboratory assessment at home. Out of our total of 97 donors, 45 returned for a full assessment and 23 completed labs and survey locally (total n = 68; 70%) after a median of 5.5 years (1.5-10.9 years) after donation. The only laboratory abnormality was a significant decrease in platelet count (median 198 ×10(9) /L versus 224 ×10(9) /L before donation; P < 0.001), whereas 93% of patients were still above normal limits. No late biliary strictures or other structural abnormalities were found on MRI/MRCP. Liver regeneration was complete. Spleen volume did significantly increase (median 278 cm(3) versus 230 cm(3) before donation; P < 0.001) without resulting in lowered platelets (P = 0.73). The most common complaints were persistent incisional numbness and changed bowel habits. Seven donors (11%) reported problems obtaining insurance. The vast majority (97%) would have donated again. In conclusion, longterm outcome following liver donation appears satisfactory. None of our donors have developed occult biliary strictures, failure of regeneration, abnormal liver function, or other important health consequences after a median of 5.5 years from surgery. These findings can be used when counseling potential donors in the future. Liver Transplantation 22 934-942 2016 AASLD.
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, the Netherlands.|Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.
authors.forename: Sarwa
authors.initials: S
authors.lastname: Darwish Murad
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, MN.
authors.forename: Jeff L
authors.initials: JL
authors.lastname: Fidler
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.
authors.forename: John J
authors.initials: JJ
authors.lastname: Poterucha
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.
authors.forename: William
authors.initials: W
authors.lastname: Sanchez
authors.affiliation: Department of Psychiatry, Mayo Clinic, Rochester, MN.
authors.forename: Sheila G
authors.initials: SG
authors.lastname: Jowsey
authors.affiliation: Division of Transplantation Surgery, Mayo Clinic, Rochester, MN.
authors.forename: David
authors.initials: D
authors.lastname: Nagorney
authors.affiliation: Division of Transplantation Surgery, Mayo Clinic, Rochester, MN.
authors.forename: Charles B
authors.initials: CB
authors.lastname: Rosen
authors.affiliation: Division of Transplantation Surgery, Mayo Clinic, Rochester, MN.
authors.forename: Julie K
authors.initials: JK
authors.lastname: Heimbach
mesh_terms: D000328:Adult; D049448:Cholangiopancreatography, Magnetic Resonance; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000601:surgery; D008115:Liver Regeneration; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010808:Physical Examination; D010976:Platelet Count; D011183:Postoperative Complications / Q000453:epidemiology; D011788:Quality of Life; D011859:Radiography; D013154:Spleen / Q000033:anatomy & histology; D011795:Surveys and Questionnaires; D013995:Time; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*; D055815:Young Adult