Donor complications including the report of one death in right-lobe living-donor liver transplantation.

BACKGROUND/AIMS: Our objective is to assess donor complications in all right hepatic lobe living-donor liver transplantation (LDLT) at our center. METHODS: Of a total of 352 liver transplantations performed, 60 were right-lobe LDLT. Most donors (88.3%) were related to the recipients. RESULTS: Mean hospital stay was 5.4+/-0.6 days. No complications occurred due to preoperative evaluation. Most donors received one or two units of autologous blood transfusion. Only 5 (8.3%) needed nonautologous blood transfusion. Most complications were minor and treated conservatively. Bile leaks from the cut surface of the liver occurred in 5 donors (8.3%). Two patients had potentially fatal complications: perforated duodenal ulcer and portal vein thrombosis (PVT). The donor with perforated ulcer developed septicemia and multiple organ failure. He was discharged from the hospital with hemiparesis due to cerebral ischemia. The patient with PVT remained asymptomatic and the portal vein was recanalized by the 3rd postoperative month. One donor died in the immediate postoperative period of cardiac arrest due to cardiac arrhythmia. CONCLUSION: Right hepatectomy for LDLT may be associated with significant morbidity, including death and it should be performed only by surgeons with great experience.

[Sexual function in males undergoing liver transplantation]. / Função sexual de homens submetidos a transplante hepático.

BACKGROUND: Sexual dysfunction is very common in liver transplantation candidates. Our objective is to determine the sexual life quality of males before and after liver transplantation. METHODS: Questionnaire was sent to 56 males over 18 years of age with at least six-month survival after orthotopic liver transplantation. The self-administered questionnaire contained 15 questions with 5 or 6 alternatives to determine the male sexual function which may be divided into 5 domains: 1) erectile function; 2) orgasmic function; 3) sexual desire; 4) intercourse satisfaction; and 5) overall satisfaction with sexual life. Each answer received a score. Domains scores were computed by summing the scores for individual answers and they were compared before and after the liver transplantation. RESULTS: Twenty-five patients answered the questionnaire completely. All 5 sexual function domains improved after liver transplantation. The score of the erectile function increased from 21.12 +/- 8.07 to 26.52 +/- 5.22 (p=0.004), of the orgasmic function from 7.28 +/- 3.05 to 9.36 +/- 1.47 (p=0.008), of the sexual desire from 6.64 +/- 2.58 to 8.68 +/- 1.35 (p=0.005), of intercourse satisfaction from 9.16 +/- 3.83 to 12.52 +/- 2.65 (p<0.0001) and of overall satisfaction from 7.12 +/- 2.64 to 9.24 +/- 1.65 (p=0.002). CONCLUSIONS: Sexual dysfunction is common in males with severe chronic liver disease and liver transplantation improves all sexual function domains: erectile function, orgasmic function, sexual desire, intercourse satisfaction and overall satisfaction.