Korean J Transplant.  2022 Nov;36(Supple 1):S54. 10.4285/ATW2022.F-1728.

Lessons learned from 261 consecutive living donor hepatectomy operations at a single center

• Lee TB
• Sim JR
• Choi BH
• Yang K
• Ryu JH

• KMID: 2535258
• DOI: http://doi.org/10.4285/ATW2022.F-1728

Abstract

Background
Due to the lack of available organs from deceased donors for transplant, living-donor liver transplantation (LDLT) has become available the most feasible treatment option for end-stage liver disease. One essential prerequisite for LDLT is the highest level of donor safety.
Methods
From May 2010 to May 2020, a total of 261 completed donor hepatectomies were performed in our center. We ana-lyzed donor morbidity associated with LDLT.
Results
The 261 donors included 182 males (69.7%) and 79 females (30.3%), ranging in age from 16 to 64 years, with a mean body mass index of 23.4 kg/m 2 . Five types of liver grafts were obtained, 117 (45%) of a modified right lobe, 113 (43%) consisting of the caudal middle hepatic vein trunk with a preserved right lobe, 16 (6%) of an extended right lobe, 14 (5%) of a left lobe, and one (1%) of a right posterior segment. The average graft weight was 686.2 g, and the average graft volume was 37.5%. No com-plications were observed in 217 (83.1%) donors, and 44 (16.9%) donors experienced complications. Pleural effusion complica-tions were most common, occurring in 12 (4.6%) patients. According to a modified Clavien classification, grade I, grade II, grade IIIa, and grade IIIb complications were experienced in 28 (10.7%), 1 (0.4%), 12 (4.6%), and 3 (1.1%) donors, respectively. Surgical or interventional management was successful in all grade IIIa and grade IIIb donors.
Conclusions
In conclusion, the majority of significant problems associated with significant living donors appear to be preventable by careful selection of living donors and graft types, rigorous postoperative monitoring, and prompt feedback on surgical approaches.