Extreme living donation: A single center simultaneous and sequential living liver-kidney donor experience with long-term outcomes under literature review
Yücel Yankol2, Cihan Karataş3, Turan Kanmaz3, Burak Koçak3, Münci Kalayoğlu3, Koray Acarlı1
1Organ Transplantion Center, Memorial Şişli Hospital, Istanbul, Turkey
2Transplant Center-Department of Surgery, Loyola University, Chicago Stritch School of Medicine, Maywood, IL, United States
3Organ Transplantion Center, Koç University Hospital, Istanbul, Turkey
Objective: Living liver and kidney donor surgeries are major surgical procedures applied to healthy people with mortality and morbidity risks not providing any direct therapeutic advantage to the donor. In this study, we aimed to share our simultaneous and sequential living liver-kidney donor experience under literature review in this worldwide rare practice.
Material and Methods: Between January 2007 and February 2018, a total of 1109 living donor nephrectomies and 867 living liver donor hepatectomies were performed with no mortality to living-related donors. Eight donors who were simultaneous or sequential living liver-kidney donors in this time period were retrospectively reviewed and presented with their minimum 2- year follow-up.
Results: Of the 8 donors, 3 of them were simultaneous and 5 of them were sequential liver-kidney donation. All of them were close relatives. Mean age was 39 (26-61) years and mean BMI was 25.7 (17.7-40). In 3 donors, right lobe, in 4 donors, left lateral sector, and in 1 donor, left lobe hepatectomy were performed. Median hospital stay was 9 (7-13) days. Two donors experienced early and late postoperative complications (Grade 3b and Grade 1). No mortality and no other long-term complication occurred.
Conclusion: Expansion of the donor pool by utilizing grafts from living donors is a globally-accepted proposition since it provides safety and successful outcomes. Simultaneous or sequential liver and kidney donation from the same donor seems to be a reasonable option for combined liver-kidney transplant recipients in special circumstances with acceptable outcomes.
Keywords: Simultaneous living liver-kidney donation, living donor hepatectomy, living donor nephrectomy, complications
Cite this article as: Yankol Y, Karataş C, Kanmaz T, Koçak B, Kalayoğlu M, Acarlı K. Extreme living donation: A single center simultaneous and sequential living liver-kidney donor experience with long-term outcomes under literature review. Turk J Surg 2021; 37 (3): 207-214.
Committee approval was received from the Memorial Şişli Hospital Institutional Review Board (09/30/2019) 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).
Concept –Y.Y.; Design – Y.Y.; Supervision –Y.Y., K.A.; Resource –M.K., K.A., B.K.; Materials - M.K., K.A., B.K., Y.Y. Data Collection and/or Processing - Y.Y., C.K., Analysis and/or Interpretation – Y.Y., T.K., Literature Search Y.Y.; Writing Manuscript – Y.Y., Critical Reviews – M.K., K.A., T.K., B.K.
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.