Perioperative Complications After Live-Donor Hepatectomy

被引:25
作者
Hall, Erin C. [1 ,2 ]
Boyarsky, Brian J. [1 ]
Deshpande, Neha A. [1 ]
Garonzik-Wang, Jacqueline M. [1 ]
Berger, Jonathan C. [1 ]
Dagher, Nabil N. [1 ]
Segev, Dorry L. [1 ,3 ]
机构
[1] Johns Hopkins Univ, Sch Med, Dept Surg, Baltimore, MD 21205 USA
[2] Georgetown Univ, Sch Med, Dept Surg, Washington, DC USA
[3] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA
基金
美国国家卫生研究院;
关键词
LIVING-DONOR; ADULT RECIPIENTS; TRANSPLANTATION; MORBIDITY; DONATION; CLASSIFICATION; JAPAN; RISK;
D O I
10.1001/jamasurg.2013.3835
中图分类号
R61 [外科手术学];
学科分类号
摘要
Current studies of complications following donor hepatectomy may not be generalizable to all hospitals performing this procedure. To address this, live liver donors were identified in the Nationwide Inpatient Sample (2000-2008). Complications after donor hepatectomy were categorized using International Classification of Diseases, Ninth Revision codes and risk factors for complications were tested using logistic regression. Negative binomial regression models were used to estimate the increase in length of stay and hospital charge associated with complications. Among 555 donors (representing 2783 donors nationwide), 23% had 1 or more complications and 5% had a major complication. The most common complications were ileus (27%) and atelectasis (26%). No patient or hospital factors were associated with complications. Having any complication was associated with increased length of stay (incidence rate ratio, 1.36; 95% CI, 1.16-1.58; P < .001) and hospital charge (incidence rate ratio, 1.25; 95% CI, 1.09-1.44; P = .002). Approximately 25% of liver donors have complications immediately postoperatively but most are minor, lending support to current practices in live liver donation and donor selection.
引用
收藏
页码:288 / 291
页数:4
相关论文
共 20 条
[1]  
Agency for Healthcare Research and Quality, HEALTHCARE COST AND
[2]   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
[3]   A NEW METHOD OF CLASSIFYING PROGNOSTIC CO-MORBIDITY IN LONGITUDINAL-STUDIES - DEVELOPMENT AND VALIDATION [J].
CHARLSON, ME ;
POMPEI, P ;
ALES, KL ;
MACKENZIE, CR .
JOURNAL OF CHRONIC DISEASES, 1987, 40 (05) :373-383
[4]   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
[5]   The Clavien-Dindo Classification of Surgical Complications Five-Year Experience [J].
Clavien, Pierre A. ;
Barkun, Jeffrey ;
de Oliveira, Michelle L. ;
Vauthey, Jean Nicolas ;
Dindo, Daniel ;
Schulick, Richard D. ;
de Santibanes, Eduardo ;
Pekolj, Juan ;
Slankamenac, Ksenija ;
Bassi, Claudio ;
Graf, Rolf ;
Vonlanthen, Rene ;
Padbury, Robert ;
Cameron, John L. ;
Makuuchi, Masatoshi .
ANNALS OF SURGERY, 2009, 250 (02) :187-196
[6]   A prospective analysis of living-liver donation shows a high rate of adverse events [J].
Dondero, F ;
Farges, O ;
Belghiti, J ;
Francoz, C ;
Sommacale, D ;
Durand, F ;
Sauvanet, A ;
Janny, S ;
Varma, D ;
Vilgrain, V .
JOURNAL OF HEPATO-BILIARY-PANCREATIC SURGERY, 2006, 13 (02) :117-122
[7]   Donor morbidity after living donation for liver transplantation [J].
Ghobrial, Rafik M. ;
Freise, Chris E. ;
Trotter, James F. ;
Tong, Lan ;
Ojo, Akinlolu O. ;
Fair, Jeffrey H. ;
Fisher, Robert A. ;
Emond, Jean C. ;
Koffron, Alan J. ;
Pruett, Timothy L. ;
Olthoff, Kim M. .
GASTROENTEROLOGY, 2008, 135 (02) :468-476
[8]   Donor Complications Associated With Living Donor Liver Transplantation in Japan [J].
Hashikura, Yasuhiko ;
Ichida, Takafumi ;
Umeshita, Koji ;
Kawasaki, Seiji ;
Mizokami, Masashi ;
Mochida, Satoshi ;
Yanaga, Katsuhiko ;
Monden, Morito ;
Kiyosawa, Kendo .
TRANSPLANTATION, 2009, 88 (01) :110-114
[9]   Living donor liver transplantation for pediatric and adult recipients [J].
Kulkarni, S ;
Malagò, M ;
Cronin, DC .
NATURE CLINICAL PRACTICE GASTROENTEROLOGY & HEPATOLOGY, 2006, 3 (03) :149-157
[10]   Complications of right lobe living donor liver transplantation [J].
Marsh, James W. ;
Gray, Edward ;
Ness, Roberta ;
Starzl, Thomas E. .
JOURNAL OF HEPATOLOGY, 2009, 51 (04) :715-724