INTRODUCTION: Right lobe donor hepatectomy (RLDH) is a potential source of liver allografts given the ongoing shortage of deceased donor organs available. Since there is no live donor registry in the United States, a population-based, unsolicited state-wide analysis has yet to be reported. METHODS: The New York (NY) State Inpatient Database was used to query 1,524 elective liver lobectomies performed from 2001 to 2006. RLDH were identified in this cohort (n = 195; 13%). Most common indications for elective right lobe hepatectomy (ERH) were metastatic colon cancer (50%) and hepatocellular carcinoma (HCC) (34%). Primary outcomes were mortality, perioperative resources and major postoperative complications. RESULTS: After a dramatic drop in 2002, there was a slow increase in RLDH from 2003 to 2006 in New York. Donors were younger (median age 36 vs. 60 years, P < 0.0001) and healthier (75% with no comorbidities vs. 18%, P < 0.0001) than patients undergoing ERH for other causes. Median length of hospital stay was 7 days in both groups. Donors were less likely to require blood transfusion (22.6 vs. 62.8%, P < 0.0001) and received less blood (mean 0.10 units vs. 2.4 units). Major post-operative complications based on the Clavien classification occurred in only 2.6% of donor cases compared to 13.8% in non-donors (P < 0.0001). There was one RLDH in-hospital mortality (0.5%) in New York compared to 4.3% after ERH (P = 0.003). CONCLUSIONS: This study represents one of the first unsolicited regional analyses of donor morbidity and resource utilization for RLDH and further emphasizes the need and utility of a live donor registry.
INTRODUCTION: Right lobe donor hepatectomy (RLDH) is a potential source of liver allografts given the ongoing shortage of deceased donor organs available. Since there is no live donor registry in the United States, a population-based, unsolicited state-wide analysis has yet to be reported. METHODS: The New York (NY) State Inpatient Database was used to query 1,524 elective liver lobectomies performed from 2001 to 2006. RLDH were identified in this cohort (n = 195; 13%). Most common indications for elective right lobe hepatectomy (ERH) were metastatic colon cancer (50%) and hepatocellular carcinoma (HCC) (34%). Primary outcomes were mortality, perioperative resources and major postoperative complications. RESULTS: After a dramatic drop in 2002, there was a slow increase in RLDH from 2003 to 2006 in New York. Donors were younger (median age 36 vs. 60 years, P < 0.0001) and healthier (75% with no comorbidities vs. 18%, P < 0.0001) than patients undergoing ERH for other causes. Median length of hospital stay was 7 days in both groups. Donors were less likely to require blood transfusion (22.6 vs. 62.8%, P < 0.0001) and received less blood (mean 0.10 units vs. 2.4 units). Major post-operative complications based on the Clavien classification occurred in only 2.6% of donor cases compared to 13.8% in non-donors (P < 0.0001). There was one RLDH in-hospital mortality (0.5%) in New York compared to 4.3% after ERH (P = 0.003). CONCLUSIONS: This study represents one of the first unsolicited regional analyses of donor morbidity and resource utilization for RLDH and further emphasizes the need and utility of a live donor registry.
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: Charles Miller; Sander Florman; Leona Kim-Schluger; Patrick Lento; Julia De La Garza; Josephine Wu; Boxun Xie; Wandi Zhang; Edward Bottone; David Zhang; Myron Schwartz Journal: Liver Transpl Date: 2004-10 Impact factor: 5.799
Authors: Jessica P Simons; Shimul A Shah; Sing Chau Ng; Giles F Whalen; Jennifer F Tseng Journal: J Gastrointest Surg Date: 2009-06-09 Impact factor: 3.452
Authors: Robert W Eppsteiner; Nicholas G Csikesz; James T McPhee; Jennifer F Tseng; Shimul A Shah Journal: Ann Surg Date: 2009-04 Impact factor: 12.969