Kaori Kuramitsu1, Takumi Fukumoto2, Tsuyoshi Kobayashi3, Kenji Fukushima2, Sho Okimoto3, Takeshi Iwasaki4, Masahiro Tominaga5, Yoh Zen6, Hideki Ohdan3, Yonson Ku2. 1. Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe City, Hyogo, Japan. kkuramit@med.kobe-u.ac.jp. 2. Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe City, Hyogo, Japan. 3. Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. 4. Department of Surgery, National Hospital Organization Kobe Medical Center, Kobe, Japan. 5. Department of Surgery, Division of Gastroenterological Surgery, Hyogo Cancer Center, Hyogo, Japan. 6. Department of Diagnostic Pathology, Graduate School of Medicine, Kobe University, Kobe, Japan.
Abstract
BACKGROUND: Although several publications have reported donor morbidities, deterioration of liver function, which may cause posthepatectomy liver failure (PHLF), was not assessed specifically. METHODS: The incidence of PHLF proposed by the International Study Group of Liver Surgery (ISGLS-PHLF) was analyzed among 257 living donors. ISGLS-PHLF was defined by an increased international normalized ratio and hyperbilirubinemia on or after postoperative day 5. RESULTS: ISGLS-PHLF was identified in 21 donors (8%), of which 18 (85.7%) were grade A, 2 (9.5%) were grade B, and 1 (4.8%) was grade C. The average hospital stay without ISGLS-PHLF was 15 ± 1 days, which extended along with increasing grades (p = 0.03). In univariate analysis, right hepatectomy was significantly associated with the incidence of ISGLS-PHLF (p = 0.02), and right hepatectomy (p = 0.002) and operation time (p = 0.01) in multivariate analysis. Of 176 right lobe donors, 19 (10.8%) developed ISGLS-PHLF, of which 16 (84.2%) were grade A, 2 (10.5%) were grade B, and 1 (5.3%) was grade C. Operation time was significantly associated with the incidence of ISGLS-PHLF in univariate (p = 0.002) and multivariate (p = 0.003) analyses. CONCLUSIONS: Right lobe donation surgery is associated with a higher incidence of ISGLS-PHLF.
BACKGROUND: Although several publications have reported donor morbidities, deterioration of liver function, which may cause posthepatectomy liver failure (PHLF), was not assessed specifically. METHODS: The incidence of PHLF proposed by the International Study Group of Liver Surgery (ISGLS-PHLF) was analyzed among 257 living donors. ISGLS-PHLF was defined by an increased international normalized ratio and hyperbilirubinemia on or after postoperative day 5. RESULTS:ISGLS-PHLF was identified in 21 donors (8%), of which 18 (85.7%) were grade A, 2 (9.5%) were grade B, and 1 (4.8%) was grade C. The average hospital stay without ISGLS-PHLF was 15 ± 1 days, which extended along with increasing grades (p = 0.03). In univariate analysis, right hepatectomy was significantly associated with the incidence of ISGLS-PHLF (p = 0.02), and right hepatectomy (p = 0.002) and operation time (p = 0.01) in multivariate analysis. Of 176 right lobe donors, 19 (10.8%) developed ISGLS-PHLF, of which 16 (84.2%) were grade A, 2 (10.5%) were grade B, and 1 (5.3%) was grade C. Operation time was significantly associated with the incidence of ISGLS-PHLF in univariate (p = 0.002) and multivariate (p = 0.003) analyses. CONCLUSIONS: Right lobe donation surgery is associated with a higher incidence of ISGLS-PHLF.
Entities:
Keywords:
ISGLS; Liver transplantation; Living donors; PHLF
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