Korean J Transplant.  2023 Nov;37(Suppl 1):S261. 10.4285/ATW2023.F-8576.

Long-term mortality of living liver donors: a systematic review and meta-analysis

• Lee N
• Kim J
• Choi Gs
• David Kwon CH
• Joh Jw

• KMID: 2551890
• DOI: http://doi.org/10.4285/ATW2023.F-8576

Abstract

Background
Although the outcome of living donor liver transplantation (LDLT) recipients has been developed, concerns remain about donor safety and moral issues. The safety of the living donor is the top priority when performing a living liver transplant. Several studies reported donor complications and mortality rate, but the results were short-term, mostly related the operation. Due to the short history of living liver transplantation, studies of the long-term survival of donors after living donor are lacking. At this point, the justification for living liver transplantation will be established only when there is a long-term result from donors after organ donation. This is a meta-analysis of long-term survival of LDLT donors.
Methods
We searched PubMed, Embase, and the Cochrane Library database for studies comparing living liver transplantation donor with control group published between the date of database creation and June 2021. Statistical analysis was performed using Revman 5.3. We included all data from recent studies and assessed methodological quality using the risk of bias from the Non-Randomized Study of Intervention (ROBINS-I) assessment tool.
Results
Three studies met the eligibility criteria. In the included clinical study, 24,371 patients received living donor surgery. In this paper, we compiled all the data on donors reported deaths from subsequent published papers on cause of death, including short-lived deaths that may be related to surgery performed within 90 days of donors. In a worldwide survey long-term deaths were reported, with suicide being the most common cause of death.
Conclusions
This meta-analysis suggests that liver donation is safe and feasible for LDLT compared to non-donation people. It is also worth mentioning that regular psychological evaluations of donors by a psychologist before and after donation were mandated. To maintain the LDLT program, careful selection and surgical technique of living liver donors are important for the safety of living liver donors.