Donor Safety in Living Donor Liver Transplantation Using Right Lobe

Hur, Hoon; Kim, Dong Goo; Choi, Sung Ho; Moon, In Sung; Lee, Myung Duk; Kim, In Chul

Abstract

PURPOSE: Right lobe donation is technically more difficult and need to define surgical technique and has more risk for surgical complication. Right lobe donation usually matched graft size but safety of donor is major concern. In this paper, we reviewed our experience of donor hepatectomy using right lobe in regarding to safe of our donor operations, retrospectively.
METHODS
Retrospective analysis of 42 donor operations for adult LDLT using right lobe was performed. We observed the patient characteristics, the operative findings, peak liver enzymes (AST, ALT, bilirubin) as donor risk and mortality, morbidity.
RESULTS
The peak value of liver enzymes in the group of less the 30% of remained liver were significantly higher than the group of more than 30% of remained liver and these values could induced the risk on donor. The postoperative peak value of liver enzymes were increased according to degree of fatty change especially in case of more than 10% fatty change even without significance. We observed the liver regeneration on postoperative 3 months and the regeneration of liver volume on postoperative 3 months was about two times compare to preoperative value and the regenerative activity was more increased in the group of less amount of remained volume. There was no donor mortality and most important complication was biliary complication, in which were biliary injury, bile leakage and biliary stricture.
CONCLUSION
Right lobectomy for donor operation requires a meticulous surgical technique to minimize donor morbidity. Right lobectomy can be performed safely with minimal risk in case of careful donor selection that the remained liver volume exceed 30% of the total liver volume and the liver of minimal fatty change.