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A prospective analysis of living‐liver donation shows a high rate of adverse events
Author(s) -
Dondero Federica,
Farges Oliver,
Belghiti Jacques,
Francoz Claire,
Sommacale Daniele,
Durand Francois,
Sauvanet Alain,
Janny Sylvie,
Varma Deepak,
Vilgrain Valerie
Publication year - 2006
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s00534-005-1017-9
Subject(s) - medicine , prospective cohort study , adverse effect , donation , incidence (geometry) , surgery , liver transplantation , transplantation , physics , optics , economics , economic growth
Donor risk is the main obstacle in the development of living‐donor liver transplantation in Western countries. The knowledge of a wide and uneven range of donor morbidity has come mainly from various retrospective analyses of complications in the literature. Donor outcomes have not been prospectively analyzed. From 1995, the intra‐ and postoperative courses of 127 living‐donor hepatectomies were prospectively analyzed and recorded. All adverse events were classified and stratified according to the extent of surgery, including 45 left‐lateral sectionectomies (LLS); 25 left hepatectomies (LH), and 57 right hepatectomies (RH). There was no donor death. The overall rate of significant complications was 20%, ranging from 8% after LH to 32% after RH. The overall incidences of surgical complications, reoperations, and hospital readmissions were 8%, 3%, and 5%, respectively. However, the prospective accumulation of all adverse events revealed an overall postoperative morbidity of 51%, ranging from 32% after LH to 66% after RH. In conclusion the incidence of postoperative adverse events after living donation is nearly 50% as revealed by prospective screening. These results allow more accurate information for potential donors. This study confirms that right hepatectomy carries three times higher risk of morbidity as compared to left‐sided resections, leading to reappraisal of the use of left grafts in adults.