Ann Surg Treat Res.  2018 Oct;95(4):213-221. 10.4174/astr.2018.95.4.213.

Intraoperative abortion of adult living donor liver transplantation: 15 cases from 1,179 cases in 20 years of experience in a single center

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. gskim@skku.edu
  • 2Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

PURPOSE
This study aimed to report intraoperative abortion of adult living donor liver transplantation (LDLT).
METHODS
From June 1997 to December 2016, 1,179 adult LDLT cases were performed. 15 cases (1.3%) of intraoperative abortions in LDLT were described.
RESULTS
Among 15 cases, 5 intraoperative abortions were donor-related, and remaining 10 cases were recipient-related. All donor-related abortions were due to unexpected steatohepatitis. Among remaining 10 recipient-related intraoperative abortions, unexpected extension of hepatocellular carcinoma was related in 5 cases. Two cases of intraoperative abortions were related to bowel inflammation, and 2 cases were associated with severe adhesion related to previous treatment. One recipient with severe pulmonary hypertension was also aborted.
CONCLUSION
Complete prevention of aborted LDLT is still not feasible. In this regard, further efforts to minimize intraoperative abortion are required.

Keyword

Abortion; Living donors; Liver transplantation; Postoperative care

MeSH Terms

Adult*
Carcinoma, Hepatocellular
Fatty Liver
Humans
Hypertension, Pulmonary
Inflammation
Liver Transplantation*
Liver*
Living Donors*
Postoperative Care

Figure

  • Fig. 1 Five-year and annual data on the incidence of intraoperative abortion.

  • Fig. 2 Intraoperative photograph of distant metastasis in expected case No. 853. White arrow, metastasis in left ilium; black arrow, metastatic mass.

  • Fig. 3 Intraoperative photograph of bowel inflammation with ischemia in expected case No. 984.


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