title: Right hepatectomy in living donors with previous abdominal surgery.
abstract: BACKGROUND
  Few studies have evaluated the impact of previous abdominal surgery (PAS) on living donor right hepatectomy (LDRH). The aim of this study was to investigate the outcomes of liver transplantation using right lobe grafts of living donors with PAS.
  
  
  METHODS
  Data were reviewed from LDRH patients at the authors' institution between March 2008 and November 2014. LDRH patients with PAS were divided into two groups according to upper PAS (group 1) or lower PAS (group 2), and they were compared to those without PAS (group 3) who were matched 1:1 based on age, gender, and body mass index. Perioperative data, complications by the Clavien classification, and the outcomes with more than 14 months follow-up were compared.
  
  
  RESULTS
  Twenty-three (4.9%) of a total of 471 LDRH donors had PAS. Eleven donors were assigned to group 1, 12 to group 2, and 23 to group 3. Intraperitoneal adhesions were found in 20 (87.0%) of 23 donors with PAS, of whom 5 (21.7%) had adhesiolysis-related injuries that happened more commonly in group 1 than in group 2 (P=0.025). LDRH was successfully completed under upper midline laparotomy in all donors. No donors received perioperative blood transfusion. The peak postoperative AST, ALT, INR, and total bilirubin levels made no difference between the three groups. Compared with group 3, groups 1 and 2 had a longer operative time (P=0.012) and a higher grade I complication rate (P=0.047). All donors recovered fully to their routine activities. The 23 recipients of grafts from donors with PAS showed good liver function with 1-year graft and patient survivals of 100%.
  
  
  CONCLUSIONS
  A history of PAS is not a contraindication to LDRH in the current era of advanced surgical techniques.
authors.affiliation: Center for Liver Cancer, National Cancer Center, 111 Jungbalsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Korea. kshlj@hanmail.net.
authors.forename: Seong Hoon
authors.initials: SH
authors.lastname: Kim
authors.forename: Seung Duk
authors.initials: SD
authors.lastname: Lee
authors.forename: Young Kyu
authors.initials: YK
authors.lastname: Kim
authors.forename: Sang-Jae
authors.initials: SJ
authors.lastname: Park
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000328:Adult; D046148:Donor Selection; D005260:Female; D006085:Graft Survival; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D000267:Tissue Adhesions; D016896:Treatment Outcome