Sema Aktaş1, Şinasi Sevmiş1, Mehmet Şeker2, Esin Korkut3, Hamdi Karakayalı1. 1. Department of General Surgery, Medipol University School of Medicine, İstanbul, Turkey. 2. Department of Radiology, Medipol University School of Medicine, İstanbul, Turkey. 3. Department of Gastroenterology, Medipol University School of Medicine, İstanbul, Turkey.
Abstract
OBJECTIVE: As might be expected, living donor liver surgery is associated with serious morbidity and mortality risks. Coagulopathy after donor hepatectomy is an important risk factor affecting morbidity. In this study, risk factors affecting the development of coagulopathy after donor hepatectomy was evaluated in a newly-established liver transplant center. MATERIAL AND METHODS: A retrospective evaluation of 46 liver donors to whom hepatectomy was applied in Medipol Universty of School of Medicine Department of Organ Transplantation between April 2014 and July 2015 was made. Coagulopathy was defined as prothrombin time ≥15 sec. or platelet count <80000/mm3 on postoperative day 3. Donors were separated into 2 groups as those with (n=24) and without (n=22) coagulopathy. Preoperative, intraoperative and postoperative factors acting on coagulopathy were analyzed. RESULTS: In the intergroup analysis, it was seen that remnant liver volume, remnant liver volume % and remnant liver volume to body weight ratio were factors associated with coagulopathy. The cut-off values for these 3 parameters were calculated as 773.5 cm3, 40.5% and 0.915 cm3/kg, respectively. Only remnant liver volume % was determined as a risk factor for coagulopathy after donor hepatectomy on multiple logistic regression analysis. CONCLUSION: The results of this study showed that the most important risk factors affecting coagulopathy after donor hepatectomy were the parameters associated with remnant liver volume.
OBJECTIVE: As might be expected, living donor liver surgery is associated with serious morbidity and mortality risks. Coagulopathy after donor hepatectomy is an important risk factor affecting morbidity. In this study, risk factors affecting the development of coagulopathy after donor hepatectomy was evaluated in a newly-established liver transplant center. MATERIAL AND METHODS: A retrospective evaluation of 46 liver donors to whom hepatectomy was applied in Medipol Universty of School of Medicine Department of Organ Transplantation between April 2014 and July 2015 was made. Coagulopathy was defined as prothrombin time ≥15 sec. or platelet count <80000/mm3 on postoperative day 3. Donors were separated into 2 groups as those with (n=24) and without (n=22) coagulopathy. Preoperative, intraoperative and postoperative factors acting on coagulopathy were analyzed. RESULTS: In the intergroup analysis, it was seen that remnant liver volume, remnant liver volume % and remnant liver volume to body weight ratio were factors associated with coagulopathy. The cut-off values for these 3 parameters were calculated as 773.5 cm3, 40.5% and 0.915 cm3/kg, respectively. Only remnant liver volume % was determined as a risk factor for coagulopathy after donor hepatectomy on multiple logistic regression analysis. CONCLUSION: The results of this study showed that the most important risk factors affecting coagulopathy after donor hepatectomy were the parameters associated with remnant liver volume.
Authors: Tina Ramspoth; Anna B Roehl; Stephan Macko; Cristoph Heidenhain; Karsten Junge; Marcel Binnebösel; Maximilian Schmeding; Ulf P Neumann; Rolf Rossaint; Marc Hein Journal: J Clin Anesth Date: 2014-11-17 Impact factor: 9.452
Authors: Patrick G Northup; Michael M Abecassis; Michael J Englesbe; Jean C Emond; Vanessa D Lee; George J Stukenborg; Lan Tong; Carl L Berg Journal: Liver Transpl Date: 2009-02 Impact factor: 5.799
Authors: Roman Schumann; Luis Zabala; Michael Angelis; Iwona Bonney; Hocine Tighiouart; Daniel B Carr Journal: Liver Transpl Date: 2004-03 Impact factor: 5.799
Authors: Yun Shin Chun; Dario Ribero; Eddie K Abdalla; David C Madoff; Melinda M Mortenson; Steven H Wei; Jean-Nicolas Vauthey Journal: J Gastrointest Surg Date: 2007-10-09 Impact factor: 3.452