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Donor safety in living related liver transplantation: Underestimation of the risks for deep vein thrombosis and pulmonary embolism
Author(s) -
Durand François,
Ettorre Giuseppe Maria,
Douard Richard,
Denninger MarieHélène,
Kianmanesh Alireza,
Sommacale Daniele,
Farges Olivier,
Valla Dominique,
Belghiti Jacques
Publication year - 2002
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1053/jlts.2002.30596
Subject(s) - medicine , pulmonary embolism , donation , deep vein , liver transplantation , thrombosis , surgery , transplantation , coagulation , intensive care medicine , living donor liver transplantation , von willebrand factor , platelet , economics , economic growth
Optimal safety for donors is a necessary condition for living related liver transplantation to expand. Although the risks for complications directly related to surgical intervention have been carefully evaluated, the extent and nature of other complications, such as pulmonary embolism, associated with living donation have not been clearly anticipated. We report a case of severe pulmonary embolism followed by ulcer‐related upper digestive tract bleeding in an adult donor after right hepatectomy. In this donor, we found an unexpected predisposing coagulation disorder (increased von Willebrand factor activity) postoperatively. This finding led us to include systematic screening for coagulation disorders during evaluation of donors, a policy which led us thereafter to reject definitely or temporarily some candidates for donation. Although the cost‐effectiveness of such investigations is not definitely established, we strongly recommend a specific approach to improve donor safety. In addition, we emphasize that the major complications observed in living donors should be systematically reported in an international database.