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Article: Safety of donors in live donor liver transplantation using right lobe grafts
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TitleSafety of donors in live donor liver transplantation using right lobe grafts
 
AuthorsFan, ST1
Lo, CM1
Liu, CL1
Yong, BH1
Chan, JKF1
Ng, IOL1
 
Issue Date2000
 
PublisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.com
 
CitationArchives Of Surgery, 2000, v. 135 n. 3, p. 336-340 [How to Cite?]
 
AbstractHypothesis: Right lobe donation was advocated for adult-to-adult live donor liver transplantation but the safety of the donor is still a major concern. We hypothesize that right lobe donation is safe if the lowest limit of volume of liver remnant that can support donor survival is known. Design: Retrospective analysis of data collected prospectively. Setting: Tertiary hepatobiliary surgery referral center. Patients: Twenty-two live donors involved in adult-to-adult right lobe liver transplantation from May 1996 to June 1999. Interventions: The right lobe grafts were obtained by transecting the liver on the left side of the middle hepatic vein. Liver transection was performed by using an ultrasonic dissector, without using the Pringle maneuver. The left lobe volume was measured by computed tomographic volumetry and the ratio of left lobe volume to the total liver volume was calculated. Main Outcome Measures: Hospital mortality rate and complication rate. Results: The median blood loss was 719 mL (range, 2001600 mL). Only one donor, who had thalassemia, received 1 U of homologous blood transfusion. Postoperative complications included wound infection, incision hernia, and cholestasis in 1 donor whose liver showed 20% fatty change and who had a left lobe-total liver volume of 0.34. Another donor with 15% fatty change in the liver and a left lobe-total liver volume ratio of 0.27 developed prolonged cholestasis. Two other donors with left lobe-total liver volume ratios of 0.27 but with mild steatosis (<5%) did not develop postoperative cholestasis. Postoperative complications also included 1 case of biliary stricture and 1 case of small bowel obstruction. Both complications were adequately treated. There was no donor mortality. All donors are well and have returned to their previous occupations. Conclusion: Live donation of right lobe graft for adult-to-adult liver transplantation is safe provided that the residual liver volume exceeds 30% of the total liver volume and the liver itself is normal or only mildly affected by steatosis.
 
ISSN0004-0010
2013 Impact Factor: 4.297
 
ISI Accession Number IDWOS:000085839300016
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorFan, ST
 
dc.contributor.authorLo, CM
 
dc.contributor.authorLiu, CL
 
dc.contributor.authorYong, BH
 
dc.contributor.authorChan, JKF
 
dc.contributor.authorNg, IOL
 
dc.date.accessioned2012-05-29T06:11:27Z
 
dc.date.available2012-05-29T06:11:27Z
 
dc.date.issued2000
 
dc.description.abstractHypothesis: Right lobe donation was advocated for adult-to-adult live donor liver transplantation but the safety of the donor is still a major concern. We hypothesize that right lobe donation is safe if the lowest limit of volume of liver remnant that can support donor survival is known. Design: Retrospective analysis of data collected prospectively. Setting: Tertiary hepatobiliary surgery referral center. Patients: Twenty-two live donors involved in adult-to-adult right lobe liver transplantation from May 1996 to June 1999. Interventions: The right lobe grafts were obtained by transecting the liver on the left side of the middle hepatic vein. Liver transection was performed by using an ultrasonic dissector, without using the Pringle maneuver. The left lobe volume was measured by computed tomographic volumetry and the ratio of left lobe volume to the total liver volume was calculated. Main Outcome Measures: Hospital mortality rate and complication rate. Results: The median blood loss was 719 mL (range, 2001600 mL). Only one donor, who had thalassemia, received 1 U of homologous blood transfusion. Postoperative complications included wound infection, incision hernia, and cholestasis in 1 donor whose liver showed 20% fatty change and who had a left lobe-total liver volume of 0.34. Another donor with 15% fatty change in the liver and a left lobe-total liver volume ratio of 0.27 developed prolonged cholestasis. Two other donors with left lobe-total liver volume ratios of 0.27 but with mild steatosis (<5%) did not develop postoperative cholestasis. Postoperative complications also included 1 case of biliary stricture and 1 case of small bowel obstruction. Both complications were adequately treated. There was no donor mortality. All donors are well and have returned to their previous occupations. Conclusion: Live donation of right lobe graft for adult-to-adult liver transplantation is safe provided that the residual liver volume exceeds 30% of the total liver volume and the liver itself is normal or only mildly affected by steatosis.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationArchives Of Surgery, 2000, v. 135 n. 3, p. 336-340 [How to Cite?]
 
dc.identifier.epage340
 
dc.identifier.hkuros48204
 
dc.identifier.isiWOS:000085839300016
 
dc.identifier.issn0004-0010
2013 Impact Factor: 4.297
 
dc.identifier.issue3
 
dc.identifier.pmid10722038
 
dc.identifier.scopuseid_2-s2.0-0034064360
 
dc.identifier.spage336
 
dc.identifier.urihttp://hdl.handle.net/10722/148200
 
dc.identifier.volume135
 
dc.languageeng
 
dc.publisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.com
 
dc.publisher.placeUnited States
 
dc.relation.ispartofArchives of Surgery
 
dc.relation.referencesReferences in Scopus
 
dc.subject.meshAdolescent
 
dc.subject.meshAdult
 
dc.subject.meshBlood Loss, Surgical - Physiopathology
 
dc.subject.meshBlood Transfusion, Autologous
 
dc.subject.meshCholestasis - Etiology
 
dc.subject.meshFemale
 
dc.subject.meshHepatectomy
 
dc.subject.meshHumans
 
dc.subject.meshIntraoperative Complications - Etiology
 
dc.subject.meshLiver Failure - Etiology
 
dc.subject.meshLiver Function Tests
 
dc.subject.meshLiver Transplantation
 
dc.subject.meshLiving Donors
 
dc.subject.meshMale
 
dc.subject.meshMiddle Aged
 
dc.subject.meshPostoperative Complications - Etiology
 
dc.subject.meshRisk Factors
 
dc.titleSafety of donors in live donor liver transplantation using right lobe grafts
 
dc.typeArticle
 
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<contributor.author>Lo, CM</contributor.author>
<contributor.author>Liu, CL</contributor.author>
<contributor.author>Yong, BH</contributor.author>
<contributor.author>Chan, JKF</contributor.author>
<contributor.author>Ng, IOL</contributor.author>
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<description.abstract>Hypothesis: Right lobe donation was advocated for adult-to-adult live donor liver transplantation but the safety of the donor is still a major concern. We hypothesize that right lobe donation is safe if the lowest limit of volume of liver remnant that can support donor survival is known. Design: Retrospective analysis of data collected prospectively. Setting: Tertiary hepatobiliary surgery referral center. Patients: Twenty-two live donors involved in adult-to-adult right lobe liver transplantation from May 1996 to June 1999. Interventions: The right lobe grafts were obtained by transecting the liver on the left side of the middle hepatic vein. Liver transection was performed by using an ultrasonic dissector, without using the Pringle maneuver. The left lobe volume was measured by computed tomographic volumetry and the ratio of left lobe volume to the total liver volume was calculated. Main Outcome Measures: Hospital mortality rate and complication rate. Results: The median blood loss was 719 mL (range, 2001600 mL). Only one donor, who had thalassemia, received 1 U of homologous blood transfusion. Postoperative complications included wound infection, incision hernia, and cholestasis in 1 donor whose liver showed 20% fatty change and who had a left lobe-total liver volume of 0.34. Another donor with 15% fatty change in the liver and a left lobe-total liver volume ratio of 0.27 developed prolonged cholestasis. Two other donors with left lobe-total liver volume ratios of 0.27 but with mild steatosis (&lt;5%) did not develop postoperative cholestasis. Postoperative complications also included 1 case of biliary stricture and 1 case of small bowel obstruction. Both complications were adequately treated. There was no donor mortality. All donors are well and have returned to their previous occupations. Conclusion: Live donation of right lobe graft for adult-to-adult liver transplantation is safe provided that the residual liver volume exceeds 30% of the total liver volume and the liver itself is normal or only mildly affected by steatosis.</description.abstract>
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<subject.mesh>Adolescent</subject.mesh>
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<subject.mesh>Blood Transfusion, Autologous</subject.mesh>
<subject.mesh>Cholestasis - Etiology</subject.mesh>
<subject.mesh>Female</subject.mesh>
<subject.mesh>Hepatectomy</subject.mesh>
<subject.mesh>Humans</subject.mesh>
<subject.mesh>Intraoperative Complications - Etiology</subject.mesh>
<subject.mesh>Liver Failure - Etiology</subject.mesh>
<subject.mesh>Liver Function Tests</subject.mesh>
<subject.mesh>Liver Transplantation</subject.mesh>
<subject.mesh>Living Donors</subject.mesh>
<subject.mesh>Male</subject.mesh>
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Author Affiliations
  1. The University of Hong Kong