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

被引:59
作者
Cho, JY
Suh, KS
Kwon, CH
Yi, NJ
Lee, HH
Park, JW
Lee, KW
Joh, JW
Lee, SK
Lee, KU
机构
[1] Seoul Natl Univ, Coll Med, Dept Surg, Seoul 110744, South Korea
[2] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Surg, Seoul, South Korea
关键词
D O I
10.1002/lt.20592
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
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 = 74), < 35% (range, 26.9-34.9) and group 2 (n = 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 +/- 79.9 and 231.5 +/- 83.3 in group 1 and 210.3 +/- 81.6 and 225.8 +/- 93.0 in group 2 (P = 0.497 and 0.699), respectively. Mean peak serum total bilirubin (TB) (mg/dL) level in group 1 (3.4 +/- 1.6) was higher than in group 2 (2.8 +/- 1.4; P = 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 = 0.939). These included bleeding (n = 3 in group 1 and n = 6 in group 2; P = 0.282), ileus (n = 3 and 1; P = 0.324), biliary leakage (n = 4 and 4; P = 0.968), and pneumonia (n = 0 and 2; P = 0.149). Minor morbidities were also comparable in the 2 groups. In conclusion, the outcome of donors with an RLV of < 35% was not different from that of donors with an RLV of >= 35%, with the exception of transient cholestasis. Therefore, a remnant RLV of < 35% does not appear to be a contraindication for right liver procurement in living donors.
引用
收藏
页码:201 / 206
页数:6
相关论文
共 26 条
[1]   Donor morbidity associated with right lobectomy for living donor liver transplantation to adult recipients: A systematic review [J].
Beavers, KL ;
Sandler, RS ;
Shrestha, R .
LIVER TRANSPLANTATION, 2002, 8 (02) :110-117
[2]   The hepatic regeneration power of mild steatotic grafts is not impaired in living-donor liver transplantation [J].
Cho, JY ;
Suh, KS ;
Kwon, CH ;
Yi, NJ ;
Cho, SY ;
Jang, JJ ;
Kim, SH ;
Lee, KU .
LIVER TRANSPLANTATION, 2005, 11 (02) :210-217
[3]   DEFINITION AND CLASSIFICATION OF NEGATIVE OUTCOMES IN SOLID-ORGAN TRANSPLANTATION - APPLICATION IN LIVER-TRANSPLANTATION [J].
CLAVIEN, PA ;
CAMARGO, CA ;
CROXFORD, R ;
LANGER, B ;
LEVY, GA ;
GREIG, PD .
ANNALS OF SURGERY, 1994, 220 (02) :109-120
[4]   Safety of donors in live donor liver transplantation using right lobe grafts [J].
Fan, ST ;
Lo, CM ;
Liu, CL ;
Yong, BH ;
Chan, JKF ;
Ng, IOL .
ARCHIVES OF SURGERY, 2000, 135 (03) :336-340
[5]   Right lobe graft in living donor liver transplantation [J].
Inomata, Y ;
Uemoto, S ;
Asonuma, K ;
Egawa, H ;
Kiuchi, T ;
Fujita, S ;
Hayashi, M ;
Kawashima, M ;
Tanaka, K .
TRANSPLANTATION, 2000, 69 (02) :258-264
[6]   Surgery-related morbidity in living donors of right-lobe liver graft: Lessons from the first 200 cases [J].
Ito, T ;
Kiuchi, T ;
Egawa, H ;
Kaihara, S ;
Oike, F ;
Ogura, Y ;
Fujimoto, Y ;
Ogawa, K ;
Tanaka, K .
TRANSPLANTATION, 2003, 76 (01) :158-163
[7]   A case of adult-to-adult living donor liver transplantation using right and left lateral lobe grafts from 2 donors [J].
Kaihara, S ;
Ogura, Y ;
Kasahara, M ;
Oike, F ;
You, YY ;
Tanaka, K .
SURGERY, 2002, 131 (06) :682-684
[8]  
KAWASAKI S, 1993, HEPATOLOGY, V18, P1115
[9]   Living related liver transplantation in adults [J].
Kawasaki, S ;
Makuuchi, M ;
Matsunami, H ;
Hashikura, Y ;
Ikegami, T ;
Nakazawa, Y ;
Chisuwa, H ;
Terada, M ;
Miyagawa, S .
ANNALS OF SURGERY, 1998, 227 (02) :269-274
[10]   Impact of graft size mismatching on graft prognosis in liver transplantation from living donors [J].
Kiuchi, T ;
Kasahara, M ;
Uryuhara, K ;
Inomata, Y ;
Uemoto, S ;
Asonuma, K ;
Egawa, H ;
Fujita, S ;
Hayashi, M ;
Tanaka, K .
TRANSPLANTATION, 1999, 67 (02) :321-327