Donor Safety in Living Donor Liver Transplantation: A Single Center Analysis of 356 Cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 MENGHai-peng , LEIJian-yong , YANGJia-yin , LIBo , WENTian-fu , ZENGYong , XUMing-qing ,  YANLü-nan

Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding?author：

YANLü-nan, Email: yanlunan688@163.com

Keywords：

Living donor liver transplantation; Donor; Complications; Safety

DOI：

10.7507/1007-9424.20150375

Video：

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Objective To evaluate donor safety in living donor liver transplantation. Methods The clinical data of 356 donors underwent living liver donation in our center from January 2001 to September 2015 were retrospectively analyzed. These patients were divided into pre-2008 group(before January 2008) and post-2008 group(after January 2008). The donor safety was evaluated with regard to three aspects, i.e. complications, liver function, and quality of life. Results ①There was no donor death in our center.②The overall complications rate was 23.3%(83/356). The proportion of ClavienⅠ, Ⅱ, Ⅲ, andⅣcomplications was 50.6%(42/83), 26.5%(22/83), 21.7%(18/83), and 1.2%(1/83), respectively. In all the donors, the incidence of ClavienⅠ, Ⅱ, Ⅲ, andⅣcomplications was 11.8%(42/356), 6.2%(22/356), 5.1%(18/356), and 0.3%(1/356), respectively. The overall complications rate in the post-2008 group was significantly lower than that in the pre-2008 group〔18.1%(41/227) versus 32.6%(42/129), P < 0.01〕. The most common complication was the biliary complication with an incidence of 8.4%(30/356).③The postoperative liver dysfunction was transient and generally retur-ned to normal level within a week.④The donor's quality of life was generally satisfied as assessed by the SF-36 tool, and 94.8%(239/252) of them would donate again if necessary. Conclusion Ever improving surgical and anesthetic techniques, together with strict donor selection and specialized perioperative management, could guarantee a low donor morbidity and a satisfactory long-term prognosis.

Citation： MENGHai-peng, LEIJian-yong, YANGJia-yin, LIBo, WENTian-fu, ZENGYong, XUMing-qing, YANLü-nan. Donor Safety in Living Donor Liver Transplantation: A Single Center Analysis of 356 Cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(12): 1428-1432. doi: 10.7507/1007-9424.20150375 Copy

1.	嚴律南, 文天夫, 李波, 等.成人-成人活體肝移植一例報告.中華肝膽外科雜志, 2002, 8(10): 634-635.
2.	Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6 336 patients and results of a survey. Ann Surg, 2004, 240(2): 205-213.
3.	李魯, 王紅妹, 沈毅. SF-36健康調查量表中文版的研制及其性能測試.中華預防醫學雜志, 2002, 36(2): 109-113.
4.	Shi ZR, Yan LN, Li B, et al. Evaluation of standard liver volume formulae for Chinese adults. World J Gastroenterol, 2009, 15(32): 4062-4066.
5.	楊家印, 李波, 王文濤, 等.腹腔鏡輔助活體供者右半肝切取臨床應用(附視頻).中華移植雜志:電子版, 2012, 6(1): 11-14.
6.	Raia S, Nery JR, Meis S. Liver transplantation from liver donor. Lancet, 1989, 2(8661): 497.
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8.	Nadalin S, Capobianco I, K?nigsrainer I, et al. Living liver donor: indications and technical aspects. Chirurg, 2015, 86(6): 609-621.
9.	Trotter JF, Adam R, Lo CM, et al. Documented deaths of hepatic lobe donors for living donor liver transplantation. Liver Transpl, 2006, 12(10): 1485-1488.
10.	Lo CM. Complications and long-term outcome of living liver donors: a survey of 1 508 cases in five Asian centers. Transplantation, 2003, 75(3 Suppl): S12-S15.
11.	Sun Z, Yu Z, Yu S, et al. Post-operative complications in living liver donors: a single-center experience in China. PLoS One, 2015, 10(8): e0135557.
12.	Laurence JM, Sapisochin G, Deangelis M, et al. Biliary complications in pediatric liver transplantation: Incidence and management over a decade. Liver Transpl, 2015, 21(8): 1082-1090.
13.	Iwasaki J, Iida T, Mizumoto M, et al. Donor morbidity in right and left hemiliver living donor liver transplantation: the impact of graft selection and surgical innovation on donor safety. Transpl Int, 2014, 27(11): 1205-1213.
14.	Rao PP, Routh D, Naidu CS, et al. Donor outcome in live-related liver transplantation. Med J Armed Forces India, 2014, 70(2): 100-104.
15.	Patel S, Orloff M, Tsoulfas G, et al. Living-donor liver transplanta-tion in the United States: identifying donors at risk for perioperative complications. Am J Transplant, 2007, 7(10): 2344-2349.
16.	Ghobrial RM, Freise CE, Trotter JF, et al. Donor morbidity after living donation for liver transplantation. Gastroenterology, 2008, 135(2): 468-476.
17.	Kousoulas L, Becker T, Richter N, et al. Living donor liver transplantation: effect of the type of liver graft donation on donor mortality and morbidity. Transpl Int, 2011, 24(3): 251-258.
18.	Al-Hamoudi W, Abaalkhail F, Bendahmash A, et al. The impact of metabolic syndrome and prevalent liver disease on living donor liver transplantation: a pressing need to expand the pool. Hepatol Int, 2015 Sep 4. [Epub ahead of print].
19.	No authors listed. Constitution of the World Health Organization. Chron World Health Organ, 1947, 1(1-2): 29-43.
20.	Xu DW, Long XD, Xia Q. A review of Life quality in living donors after liver transplantation. Int J Clin Exp Med, 2015, 8(1): 20-26.
21.	Zein NN, Hanouneh IA, Bishop PD, et al. Three-dimensional print of a liver for preoperative planning in living donor liver transplantation. Liver Transpl, 2013, 19(12): 1304-1310.

1. 嚴律南, 文天夫, 李波, 等.成人-成人活體肝移植一例報告.中華肝膽外科雜志, 2002, 8(10): 634-635.
2. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6 336 patients and results of a survey. Ann Surg, 2004, 240(2): 205-213.
3. 李魯, 王紅妹, 沈毅. SF-36健康調查量表中文版的研制及其性能測試.中華預防醫學雜志, 2002, 36(2): 109-113.
4. Shi ZR, Yan LN, Li B, et al. Evaluation of standard liver volume formulae for Chinese adults. World J Gastroenterol, 2009, 15(32): 4062-4066.
5. 楊家印, 李波, 王文濤, 等.腹腔鏡輔助活體供者右半肝切取臨床應用(附視頻).中華移植雜志:電子版, 2012, 6(1): 11-14.
6. Raia S, Nery JR, Meis S. Liver transplantation from liver donor. Lancet, 1989, 2(8661): 497.
7. 嚴律南.活體肝移植的現狀與展望.中國普外基礎與臨床雜志, 2007, 14(2): 128-131.
8. Nadalin S, Capobianco I, K?nigsrainer I, et al. Living liver donor: indications and technical aspects. Chirurg, 2015, 86(6): 609-621.
9. Trotter JF, Adam R, Lo CM, et al. Documented deaths of hepatic lobe donors for living donor liver transplantation. Liver Transpl, 2006, 12(10): 1485-1488.
10. Lo CM. Complications and long-term outcome of living liver donors: a survey of 1 508 cases in five Asian centers. Transplantation, 2003, 75(3 Suppl): S12-S15.
11. Sun Z, Yu Z, Yu S, et al. Post-operative complications in living liver donors: a single-center experience in China. PLoS One, 2015, 10(8): e0135557.
12. Laurence JM, Sapisochin G, Deangelis M, et al. Biliary complications in pediatric liver transplantation: Incidence and management over a decade. Liver Transpl, 2015, 21(8): 1082-1090.
13. Iwasaki J, Iida T, Mizumoto M, et al. Donor morbidity in right and left hemiliver living donor liver transplantation: the impact of graft selection and surgical innovation on donor safety. Transpl Int, 2014, 27(11): 1205-1213.
14. Rao PP, Routh D, Naidu CS, et al. Donor outcome in live-related liver transplantation. Med J Armed Forces India, 2014, 70(2): 100-104.
15. Patel S, Orloff M, Tsoulfas G, et al. Living-donor liver transplanta-tion in the United States: identifying donors at risk for perioperative complications. Am J Transplant, 2007, 7(10): 2344-2349.
16. Ghobrial RM, Freise CE, Trotter JF, et al. Donor morbidity after living donation for liver transplantation. Gastroenterology, 2008, 135(2): 468-476.
17. Kousoulas L, Becker T, Richter N, et al. Living donor liver transplantation: effect of the type of liver graft donation on donor mortality and morbidity. Transpl Int, 2011, 24(3): 251-258.
18. Al-Hamoudi W, Abaalkhail F, Bendahmash A, et al. The impact of metabolic syndrome and prevalent liver disease on living donor liver transplantation: a pressing need to expand the pool. Hepatol Int, 2015 Sep 4. [Epub ahead of print].
19. No authors listed. Constitution of the World Health Organization. Chron World Health Organ, 1947, 1(1-2): 29-43.
20. Xu DW, Long XD, Xia Q. A review of Life quality in living donors after liver transplantation. Int J Clin Exp Med, 2015, 8(1): 20-26.
21. Zein NN, Hanouneh IA, Bishop PD, et al. Three-dimensional print of a liver for preoperative planning in living donor liver transplantation. Liver Transpl, 2013, 19(12): 1304-1310.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Donor Safety in Living Donor Liver Transplantation: A Single Center Analysis of 356 Cases

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