Residual liver volume as a predictive value for donor outcome in adult right lobe living donor liver transplant

Background Right lobe liver donation is a widely accepted procedure that results in the expansion of the indication for living donor liver transplantation (LDLT). Precise preoperative evaluation of a donor is important for performing LDLT successfully and safely in both the recipient and the donor. Objective The aim was to evaluate postoperative donor outcome regarding liver functions and complications after adult right lobe LDLT with different residual liver volumes. Design A prospective study was conducted. Patients and methods Between September 2014 and April 2016, we prospectively compared 41 donors having a remnant liver volume (RLV) of 35-40% (group A) with 42 donors having a RLV of 41-49% (group B) for donor outcomes. All the complications in donors were systematically classified. Results Donors of the group A showed significantly higher peak international normalized ratio and bilirubin levels and lower albumin level than group B. The incidence of postoperative complications was seen in 15 (36.6%) patients in group A and in nine (21.4%) patients in group B. The overall incidence of complications was 28.9%. Conclusion The use of donors with more than 35% RLV is safe regarding the postoperative donor outcome. The use of donors with less than 35% RLV is controversial, so, we recommend more advanced studies on lower RLV less than 35% to increase pool of potential donors for LDLT, especially in countries in which deceased donor liver transplantation is still forbidden.