BACKGROUND & AIMS: Reports of complications among adult right hepatic lobe donors have been limited to single centers. The rate and severity of complications in living donors were investigated in the 9-center Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL). METHODS: A retrospective observational study design was used. Participants included all potential living donors evaluated between 1998 and 2003. Complication severity was graded using the Clavien scoring system. RESULTS: Of 405 donors accepted for donation, 393 underwent donation, and 12 procedures were aborted. There were 245 donors (62%) who did not experience complications; 82 (21%) had 1 complication, and 66 (17%) had 2 or more. Complications were scored as grade 1 (minor; n = 106, 27%), grade 2 (potentially life threatening; n = 103, 26%), grade 3 (life threatening; n = 8, 2%), and grade 4 (leading to death; n = 3, 0.8%). Common complications included biliary leaks beyond postoperative day 7 (n = 36, 9%), bacterial infections (n = 49, 12%), incisional hernia (n = 22, 6%), pleural effusion requiring intervention (n = 21, 5%), neuropraxia (n = 16, 4%), reexploration (n = 12, 3%), wound infections (n = 12, 3%), and intraabdominal abscess (n = 9, 2%). Two donors developed portal vein thrombosis, and 1 had inferior vena caval thrombosis. Fifty-one (13%) donors required hospital readmission, and 14 (4%) required 2 to 5 readmissions. CONCLUSIONS: Adult living liver donation was associated with significant donor complications. Although most complications were of low-grade severity, a significant proportion were severe or life threatening. Quantification of complication risk may improve the informed consent process, perioperative planning, and donor care.
BACKGROUND & AIMS: Reports of complications among adult right hepatic lobe donors have been limited to single centers. The rate and severity of complications in living donors were investigated in the 9-center Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL). METHODS: A retrospective observational study design was used. Participants included all potential living donors evaluated between 1998 and 2003. Complication severity was graded using the Clavien scoring system. RESULTS: Of 405 donors accepted for donation, 393 underwent donation, and 12 procedures were aborted. There were 245 donors (62%) who did not experience complications; 82 (21%) had 1 complication, and 66 (17%) had 2 or more. Complications were scored as grade 1 (minor; n = 106, 27%), grade 2 (potentially life threatening; n = 103, 26%), grade 3 (life threatening; n = 8, 2%), and grade 4 (leading to death; n = 3, 0.8%). Common complications included biliary leaks beyond postoperative day 7 (n = 36, 9%), bacterial infections (n = 49, 12%), incisional hernia (n = 22, 6%), pleural effusion requiring intervention (n = 21, 5%), neuropraxia (n = 16, 4%), reexploration (n = 12, 3%), wound infections (n = 12, 3%), and intraabdominal abscess (n = 9, 2%). Two donors developed portal vein thrombosis, and 1 had inferior vena caval thrombosis. Fifty-one (13%) donors required hospital readmission, and 14 (4%) required 2 to 5 readmissions. CONCLUSIONS: Adult living liver donation was associated with significant donor complications. Although most complications were of low-grade severity, a significant proportion were severe or life threatening. Quantification of complication risk may improve the informed consent process, perioperative planning, and donor care.
Authors: P A Clavien; J R Sanabria; G Mentha; F Borst; L Buhler; B Roche; R Cywes; R Tibshirani; A Rohner; S M Strasberg Journal: Ann Surg Date: 1992-12 Impact factor: 12.969
Authors: Kim M Olthoff; Robert M Merion; Rafik M Ghobrial; Michael M Abecassis; Jeffrey H Fair; Robert A Fisher; Chris E Freise; Igal Kam; Timothy L Pruett; James E Everhart; Tempie E Hulbert-Shearon; Brenda W Gillespie; Jean C Emond Journal: Ann Surg Date: 2005-09 Impact factor: 12.969
Authors: Y Hashikura; M Makuuchi; S Kawasaki; H Matsunami; T Ikegami; Y Nakazawa; K Kiyosawa; T Ichida Journal: Lancet Date: 1994-05-14 Impact factor: 79.321
Authors: A Marcos; R A Fisher; J M Ham; M L Shiffman; A J Sanyal; V A Luketic; R K Sterling; M P Posner Journal: Transplantation Date: 1999-09-27 Impact factor: 4.939
Authors: M E Wachs; T E Bak; F M Karrer; G T Everson; R Shrestha; T E Trouillot; M S Mandell; T G Steinberg; I Kam Journal: Transplantation Date: 1998-11-27 Impact factor: 4.939
Authors: Rafik M Ghobrial; Sammy Saab; Charles Lassman; David S k Lu; Steven Raman; Piyagorn Limanond; Greg Kunder; Karyn Marks; Farin Amersi; Dean Anselmo; Pauline Chen; Douglas Farmer; Steven Han; Francisco Durazo; Leonard I Goldstein; Ronald W Busuttil Journal: Liver Transpl Date: 2002-10 Impact factor: 5.799
Authors: Salvatore Gruttadauria; Fabrizio di Francesco; Duilio Pagano; Sergio Li Petri; Davide Cintorino; Marco Spada; Bruno Gridelli Journal: World J Gastrointest Surg Date: 2010-03-27