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Article: Safety of donors in live donor liver transplantation using right lobe grafts

TitleSafety of donors in live donor liver transplantation using right lobe grafts
Authors
Issue Date2000
PublisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.com
Citation
Archives 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.
Persistent Identifierhttp://hdl.handle.net/10722/148200
ISSN
2014 Impact Factor: 4.926
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorFan, STen_US
dc.contributor.authorLo, CMen_US
dc.contributor.authorLiu, CLen_US
dc.contributor.authorYong, BHen_US
dc.contributor.authorChan, JKFen_US
dc.contributor.authorNg, IOLen_US
dc.date.accessioned2012-05-29T06:11:27Z-
dc.date.available2012-05-29T06:11:27Z-
dc.date.issued2000en_US
dc.identifier.citationArchives Of Surgery, 2000, v. 135 n. 3, p. 336-340en_US
dc.identifier.issn0004-0010en_US
dc.identifier.urihttp://hdl.handle.net/10722/148200-
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.en_US
dc.languageengen_US
dc.publisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.comen_US
dc.relation.ispartofArchives of Surgeryen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshBlood Loss, Surgical - Physiopathologyen_US
dc.subject.meshBlood Transfusion, Autologousen_US
dc.subject.meshCholestasis - Etiologyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHepatectomyen_US
dc.subject.meshHumansen_US
dc.subject.meshIntraoperative Complications - Etiologyen_US
dc.subject.meshLiver Failure - Etiologyen_US
dc.subject.meshLiver Function Testsen_US
dc.subject.meshLiver Transplantationen_US
dc.subject.meshLiving Donorsen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPostoperative Complications - Etiologyen_US
dc.subject.meshRisk Factorsen_US
dc.titleSafety of donors in live donor liver transplantation using right lobe graftsen_US
dc.typeArticleen_US
dc.identifier.emailFan, ST:stfan@hku.hken_US
dc.identifier.emailLo, CM:chungmlo@hkucc.hku.hken_US
dc.identifier.emailNg, IOL:iolng@hkucc.hku.hken_US
dc.identifier.authorityFan, ST=rp00355en_US
dc.identifier.authorityLo, CM=rp00412en_US
dc.identifier.authorityNg, IOL=rp00335en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1001/archsurg.135.3.336-
dc.identifier.pmid10722038en_US
dc.identifier.scopuseid_2-s2.0-0034064360en_US
dc.identifier.hkuros48204-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0034064360&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume135en_US
dc.identifier.issue3en_US
dc.identifier.spage336en_US
dc.identifier.epage340en_US
dc.identifier.isiWOS:000085839300016-
dc.publisher.placeUnited Statesen_US
dc.identifier.issnl0004-0010-

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