Analysis of Postoperative Liver Function and Complications versus Donor Hepatectomy Type for Living-Related Liver Transplantation / 대한마취과학회지

ABSTRACT

BACKGROUND: Although living related liver transplantation (LRLT) has several advantages over cadaveric liver transplantation, there still is considerable debate concerning donor safety. We analyzed postoperative liver function and complications versus type of donor hepatectomy for LRLT. METHODS: The charts, anesthetic records and computerized hospital data of 135 consecutive donors registered for LRLT from June 1996 to February 2003 were retrospectively reviewed. Donors were divided into three groups a left lateral segmentectomy (group LLS; n = 37), a left lobectomy (group LL; n = 8), and a right lobectomy (group RL; n = 90). Volume and weight of the resected liver, volume of blood loss, fluids and blood administered, surgical time and anesthetic time, duration of hospital stay, complications, and perioperative changes in hemoglobin (Hb), aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and prothrombin time (PT) were investigated. RESULTS: No significant differences in donor characteristics, blood loss, and duration of hospital stay were observed. But surgical and anesthetic times in the group RL were longest. The postoperative peak level of AST and ALT in the group LLS were significantly higher than those of the other groups. Postoperative PT and total bilirubin in the group RL were highest. AST, ALT, and PT peaked on the first postoperative day and decreased gradually thereafter. None of the donors experienced a critical complication, including liver failure. CONCLUSIONS: Significant differences in surgical time, postoperative liver function and incidence of hyperbilirubinemia were observed according to the type of hepatectomy. But, serious complication occurred in any donor.