Complications in 100 living-liver donors

被引:141
作者
Grewal, HP
Thistlethwaite, JR
Loss, GE
Fisher, JS
Cronin, DC
Siegel, CT
Newell, KA
Bruce, DS
Woodle, ES
Brady, L
Kelly, S
Boone, P
Oswald, K
Millis, JM
机构
[1] Univ Chicago, Dept Surg, Sect Transplantat, Chicago, IL 60637 USA
[2] Univ Chicago, Sect Pediat Gastroenterol, Chicago, IL 60637 USA
关键词
D O I
10.1097/00000658-199808000-00011
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objective A review of 100 living-liver donors was performed to evaluate the perisurgical complications of the procedure and thus to help quantify the risks to the donor. Summary Background Data Despite the advantages of living-donor liver transplantation (LDLT), the procedure has received criticism for the risk it imposes on healthy persons. A paucity of data exists regarding the complications and relative safety of the procedure. Methods One hundred LDLTs performed between November 1989 and November 1996 were reviewed. Donor data were obtained by chart review, anesthesia records, and the computerized hospital data base. Patient variables were compared by Fisher's exact test and the Student's t test. Results There were 57 women and 43 men with a median age of 29. Donors were divided into two groups: group A (first 50 donors), and group B (last 50 donors). There were 91 left lateral segments and 9 left lobes. There were no deaths. Fourteen major complications occurred in 13 patients; 9 occurred in group A and 5 in group B. Biliary complications consisted of five bile duct injuries (group A = 4, group B = 1) and two cut edge bile leaks. Complications were more common in left lobe resections (55%) than in left lateral segment grafts (10%). Minor complications occurred in 20% of patients. A significant reduction in overall complications (major and minor) was observed between the groups (group A, n = 24 [45%] vs. group B, n = 10 [20%]). In addition, surgical time and hospital stay were both significantly reduced. Conclusions Although the procedure is safe, many LDLT donors have a perisurgical complication. Surgical experience and technical modifications have resulted in a significant reduction in these complications, however. To minimize the risks for these healthy donors, LDLT should be performed at institutions with extensive experience.
引用
收藏
页码:214 / 219
页数:6
相关论文
共 25 条
[1]   Allograft rejection in pediatric recipients of living related liver transplants [J].
Alonso, EM ;
Piper, JB ;
Echols, G ;
Thistlethwaite, JR ;
Whitington, PF .
HEPATOLOGY, 1996, 23 (01) :40-43
[2]   LIVER-TRANSPLANTATION IN CHILDREN FROM LIVING RELATED DONORS - SURGICAL TECHNIQUES AND RESULTS [J].
BROELSCH, CE ;
WHITINGTON, PF ;
EMOND, JC ;
HEFFRON, TG ;
THISTLETHWAITE, JR ;
STEVENS, L ;
PIPER, J ;
WHITINGTON, SH ;
LICHTOR, JL .
ANNALS OF SURGERY, 1991, 214 (04) :428-439
[3]   REGENERATION OF MAMMALIAN LIVER [J].
BUCHER, NLR .
INTERNATIONAL REVIEW OF CYTOLOGY-A SURVEY OF CELL BIOLOGY, 1963, 15 :245-300
[4]   LIVING RELATED KIDNEY DONORS - A 14-YEAR EXPERIENCE [J].
DUNN, JF ;
RICHIE, RE ;
MACDONELL, RC ;
NYLANDER, WA ;
JOHNSON, HK ;
SAWYERS, JL .
ANNALS OF SURGERY, 1986, 203 (06) :637-643
[5]   IMPROVED RESULTS OF LIVING-RELATED LIVER-TRANSPLANTATION WITH ROUTINE APPLICATION IN A PEDIATRIC PROGRAM [J].
EMOND, JC ;
HEFFRON, TG ;
KORTZ, EO ;
GONZALEZVALLINA, R ;
CONTIS, JC ;
BLACK, DD ;
WHITINGTON, PF ;
MAKOWKA ;
ILDSTAD .
TRANSPLANTATION, 1993, 55 (04) :835-840
[6]  
Emond JC, 1996, TRANSPLANT P, V28, P2375
[7]  
EMOND JC, 1994, ATLAS ORGAN TRANSPLA
[8]  
IWASAKI S, 1983, ANN SURG, V197, P247
[9]   LIVING-DONOR LIVER-TRANSPLANTATION AT UCLA [J].
JURIM, O ;
SHACKLETON, CR ;
MCDIARMID, SV ;
MARTIN, P ;
SHAKED, A ;
MILLIS, JM ;
IMAGAWA, DK ;
OLTHOFF, KM ;
MAXFIELD, A ;
PAKRASI, AL ;
MELINEK, J ;
AMENT, M ;
VARGAS, J ;
GOLDSTEIN, LI ;
BUSUTTIL, RW .
AMERICAN JOURNAL OF SURGERY, 1995, 169 (05) :529-532
[10]   LIVER-REGENERATION IN RECIPIENTS AND DONORS AFTER TRANSPLANTATION [J].
KAWASAKI, S ;
MAKUUCHI, M ;
ISHIZONE, S ;
MATSUNAMI, H ;
TERADA, M ;
KAWARAZAKI, H .
LANCET, 1992, 339 (8793) :580-581