Complications and outcomes of 890 living liver donor hepatectomies at a single center: risks of saving loved one’s life
Yücel Yankol1,2, Nesimi Mecit1,3, Turan Kanmaz1,3, Münci Kalayoğlu1,3<(sup>, Koray Acarlı1
1Organ Transplantation Center, Memorial Sisli Hospital, Istanbul, Turkey
2Department of Surgery Division of Transplantation, University of Wisconsin, Madison, WI, United States of America
3Organ Transplantation Center, Koc University School of Medicine Hospital, Istanbul, Turkey
Abstract
Objective: Living liver donor surgery is a major surgical procedure applied to healthy people with mortality and morbidity risks and does not provide any direct therapeutic advantage to the donor. We retrospectively analyzed the postoperative complication of our living liver donors to figure out the risks of donation.
Material and Methods: Between November, 2006 and December, 2018, a total of 939 living liver donor hepatectomies were performed with no mortality to the living-related donors. Eight hundred and ninety donors with a minimum 1-year follow-up were analyzed retrospectively.
Results: Of the 890 donors, 519 (58.3%) were males and 371 (41.7%) were females. Mean age was 35 years (18-64) and mean body mass index was 25.7 kg/m2 (17.7-40). Right donor hepatectomy was performed to 601 (67.5%), left donor hepatectomy to 28 (3.2%) and left lateral sector hepatectomy to 261 (29.3%) of the donors. Of the 890 donors, 174 (19.5%) donors experienced a total of 204 early and late complications including life- threatening and nearly life- threatening complications in 26 (2.9%) of them. Intraoperative complication occurred in 4 (0.5%) donors. Right donors hepatectomy complication rate (23.3%) was higher than left donor (14.3%) and left lateral sector donor hepatectomy (11.5%).
Conclusion: All donor candidates should be well-informed not only on the details of early and late complications of living liver donation, also possible outcomes of the recipient. In addition to detailed physical evaluation, preoperative psychosocial evaluation is also mandatory. Comprehensive donor evaluation, surgical experience, surgical technique, close postoperative follow-up and establishing a good dialog with the donor allows better outcomes.
Keywords: Living donor hepatectomy, complications, outcomes, living liver donor transplantation, life-threatening complications
Cite this article as: Yankol Y, Mecit N, Kanmaz T, Kalayoğlu M, Acarlı K. Complications and outcomes of 890 living liver donor hepatectomies at a single center: risks of saving loved one’s life. Turk J Surg 2020; 36 (2): 192-201.
Authors declared that the research was conducted according to the principles of the World Medical Association Declaration of Helsinki “Ethical Principles for Medical Research Involving Human Subjects” (amended in October 2013). Authors declared that the content of this manuscript complies with all the rules of the “Call for an end to unethical transplant practices” by The Transplantation Society (Transplantation.2019 Apr;103(4):647.) and The Declaration of Istanbul on Organ Trafficking and Transplant Tourism (Transplantation. 2008 Oct ;86(8):1013-8.).
Written informed consent was obtained from patients who participated in this study.
Externally peer-reviewed.
Concept – Y.Y.; Design – Y.Y., K.A.; Supervision – Y.Y., K.A.; Resource – Y.Y., M.K., K.A.; Materials Y.Y., M.K., K.A.; Data Collection and/or Processing - Y.Y., N.M.; Analysis and/or Interpretation - Y.Y., T.K.; Literature Search Y.Y.; Writing Manuscript – Y.Y.; Critical Reviews – T.K., M.K., K.A.
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.