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Outcome of donors with a remnant liver volume of less than 35% after right hepatectomy

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Authors
Cho, Jai Young; Suh, Kyung-Suk; Kwon, Choon Hyuck; Yi, Nam-Joon; Lee, Hwan Hyo; Park, Jean Wan; Lee, Kwang-Woong; Joh, Jae Won; Lee, Suk-Koo; Lee, Kuhn Uk
Issue Date
2006-02-01
Publisher
John Wiley & Sons
Citation
Liver Transpl. 2006 Feb;12(2):201-6
Keywords
AdolescentAdultAge DistributionCohort StudiesFemaleFollow-Up StudiesGraft Rejection/prevention & controlHepatectomy/adverse effects/*methodsHumansIncidenceLiver Function TestsLiver Regeneration/*physiologyLiver Transplantation/adverse effects/*methods*Living DonorsMaleMiddle AgedOrgan Preservation/methodsOrgan SizePostoperative Complications/*diagnosis/epidemiologyProbabilityRisk AssessmentSex Distribution
Abstract
To overcome the barrier of size match, right lobe graft has been widely used in living donor liver transplantation (LDLT). We assessed donor outcome, with a focus on remnant liver volume (RLV) after right hepatectomy based on the experiences of 2 LDLT centers, as a means of guiding the establishment of safe RLV limits for donor right hepatectomy. Between January 2002 and December 2003, a consecutive 146 liver donors who underwent right hepatectomy with at least 12 months of follow-up were enrolled in this study. Donors were grouped into 2 groups according to RLV: group 1 (n = 74), <35% (range, 26.9-34.9) and group 2 (n = 72), > or = 35% (35.0-46.8). No donors died or suffered a life-threatening complication. Mean peak serum postoperative aspartate aminotransferase (AST) and alanine aminotransferase (ALT) (IU/L) levels were 219.5 +/- 79.9 and 231.5 +/- 83.3 in group 1 and 210.3 +/- 81.6 and 225.8 +/- 93.0 in group 2 (P = 0.497 and 0.699), respectively. Mean peak serum total bilirubin (TB) (mg/dL) level in group 1 (3.4 +/- 1.6) was higher than in group 2 (2.8 +/- 1.4; P = 0.023). Overall 23 (15.8%) major morbidities, 10 in group 1 (13.5%) and 13 in group 2 (18.1%), occurred according to Clavien's system (P = 0.939). These included bleeding (n = 3 in group 1 and n = 6 in group 2; P = 0.282), ileus (n = 3 and 1; P = 0.324), biliary leakage (n = 4 and 4; P = 0.968), and pneumonia (n = 0 and 2; P = 0.149). Minor morbidities were also comparable in the 2 groups. In conclusion, the outcome of donors with an RLV of <35% was not different from that of donors with an RLV of > or = 35%, with the exception of transient cholestasis. Therefore, a remnant RLV of <35% does not appear to be a contraindication for right liver procurement in living donors.
ISSN
1527-6465 (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16447201

http://hdl.handle.net/10371/15532
DOI
https://doi.org/10.1002/lt.20592
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College of Medicine/School of Medicine (의과대학/대학원)Surgery (외과학전공)Journal Papers (저널논문_외과학전공)
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