Donor safety in living donor liver transplantation

✍ Scribed by Sheung-Tat Fan

• Publisher: John Wiley and Sons
• Year: 2000
• Tongue: English
• Weight: 18 KB
• Volume: 6
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.500060211

✦ Synopsis

We read with great concern the recent provocative editorial on living related liver transplantation. 1 It raises important issues about the safety of the procedure for the donor. Dr Strong mentions that he ''is aware of at least 6 deaths'' that have occurred with the procedure. Only 1 death has apparently been reported in the literature. 2 As clinicians involved in the evaluation of the living donor, we strive to present accurate information on the risks of the procedure. Our program is structured so that we are not involved in the management of either the adult or pediatric recipient, a formula designed to avoid potential bias in the communication between the potential donor and the counseling physician. If the mortality of this surgery is truly as high as reported by the editorialist, a very different message needs to be conveyed to the patient.

We would have hoped that an editorial would comment on such momentous data by providing proof of the facts. It is incumbent that Dr Strong respond to this letter by providing a detailed analysis of the circumstances that purportedly lead to the donors' demise. Were they related to pediatric or adult donation? Segmentectomies or lobectomies? Part of the initial experience at a center (the learning-curve effect) or deaths in well-established programs?

In the absence of a detailed response, the nature of his editorial can only be interpreted as a rumor, and we are sure that Dr Strong does not wish rumors to be used as the basis for patient counseling.