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Outcome of donors with a remnant liver volume of less than 35% after right hepatectomy

โœ Scribed by Jai Young Cho; Kyung-Suk Suh; Choon Hyuck Kwon; Nam-Joon Yi; Hwan Hyo Lee; Jean Wan Park; Kwang-Woong Lee; Jae Won Joh; Suk-Koo Lee; Kuhn Uk Lee


Book ID
102471774
Publisher
John Wiley and Sons
Year
2006
Tongue
English
Weight
141 KB
Volume
12
Category
Article
ISSN
1527-6465

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โœฆ Synopsis


To overcome the barrier of size match, right lobe graft has been widely used in living donor liver transplantation (LDLT). We assessed donor outcome, with a focus on remnant liver volume (RLV) after right hepatectomy based on the experiences of 2 LDLT centers, as a means of guiding the establishment of safe RLV limits for donor right hepatectomy. Between January 2002 and December 2003, a consecutive 146 liver donors who underwent right hepatectomy with at least 12 months of follow-up were enrolled in this study. Donors were grouped into 2 groups according to RLV: group 1 (n ฯญ 74), ฯฝ35% (range, 26.9-34.9) and group 2 (n ฯญ 72), ี†35% (35.0-46.8). No donors died or suffered a life-threatening complication. Mean peak serum postoperative aspartate aminotransferase (AST) and alanine aminotransferase (ALT) (IU/L) levels were 219.5 ฯฎ 79.9 and 231.5 ฯฎ 83.3 in group 1 and 210.3 ฯฎ 81.6 and 225.8 ฯฎ 93.0 in group 2 (P ฯญ 0.497 and 0.699), respectively. Mean peak serum total bilirubin (TB) (mg/dL) level in group 1 (3.4 ฯฎ 1.6) was higher than in group 2 (2.8 ฯฎ 1.4; P ฯญ 0.023). Overall 23 (15.8%) major morbidities, 10 in group 1 (13.5%) and 13 in group 2 (18.1%), occurred according to Clavien's system (P ฯญ 0.939). These included bleeding (n ฯญ 3 in group 1 and n ฯญ 6 in group 2; P ฯญ 0.282), ileus (n ฯญ 3 and 1; P ฯญ 0.324), biliary leakage (n ฯญ 4 and 4; P ฯญ 0.968), and pneumonia (n ฯญ 0 and 2; P ฯญ 0.149). Minor morbidities were also comparable in the 2 groups. In conclusion, the outcome of donors with an RLV of ฯฝ35% was not different from that of donors with an RLV of ี†35%, with the exception of transient cholestasis. Therefore, a remnant RLV of ฯฝ35% does not appear to be a contraindication for right liver procurement in living donors.


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