Safety of Donor in Adult-to-Adult Living Donor Liver Transplantation

ABSTRACT

PURPOSE: Right lobe donation was advocated to overcome size-mismatch between left lobe and larger-size recipient in living donor liver transplantation (LDLT), however, safety of donor is a major concern. The purpose of this study is to evaluate the safety of donor in adult-to-adult LDLT. METHODS: Retrospective analysis of 104 adult-to-adult LDLT was performed by comparison of left lobectomy (n=50) and right lobectomy (n=54) groups. RESULTS: The median age of donors was 28 years and offsprings were most common donors (33.7%). The right lobe graft provided larger mass by 60% than left lobe. The ratio of residual liver volume to total liver volume, operation time, intraoperative blood loss, and postoperative ICU stay showed significant differences in both groups. Recovery of liver profiles was delayed by several days in right lobectomy group, but all donors recovered uneventfully. There was no mortality nor sequela in both groups. Severe postoperative complications occured more frequently in right lobectomy group, and they were bile leakage (n=3), postoperative bleeding (n=5), and portal vein thrombosis (n=1). All complications were controlled with safety. CONCLUSION: Right lobe harvesting can be safe but should be performed only by expert operators because there is potential operative risk. To minimize operative complications, attention should be paid to every step of procedures and to postoperative surveillance.