Perioperative management and complications in donors related to living-donor liver transplantation

• Published in: Surgery Vol. 131; no. 1; pp. S195 - S199
• Main Authors: Soejima, Yuji, Harada, Noburu, Shimada, Mitsuo, Suehiro, Taketoshi, Minagawa, Ryosuke, Hiroshige, Shoji, Ninomiya, Mizuki, Shiotani, Satoko, Nishizaki, Takashi
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 2002; Elsevier
• Subjects: Adult; Biliary Atresia - epidemiology; Biliary Atresia - surgery; Biological and medical sciences; Child; Cholangitis, Sclerosing - epidemiology; Cholangitis, Sclerosing - surgery; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Liver Cirrhosis, Biliary - epidemiology; Liver Cirrhosis, Biliary - surgery; Liver Failure - epidemiology; Liver Failure - surgery; Liver Transplantation; Liver, biliary tract, pancreas, portal circulation, spleen; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Living Donors; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Perioperative Care - methods; Postoperative Complications - epidemiology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Human; Treatment; Indication; Surgery; Living donor; Liver; Related donor; Digestive diseases; Complication; Hepatic disease; Transplantation
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1067/msy.2002.119576

Living-donor liver transplantation has become a legitimate alternative to cadaveric liver transplantation. However, information on the perioperative management of donors is still scarce.
Between October 1996 and May 2001, 52 consecutive living-donor liver transplantations have been performed at the authors' institution. The preoperative and postoperative management of donors, operative technique, and complications are herein described.
All donors were discharged from the hospital alive and well, and all returned to their normal lifestyle without any significant adverse sequelae after a mean hospital stay of13 days after the operation. Overall, 24 complications occurred, all of which could be managed conservatively, except for one case of hepatic duct stricture that required a relaparotomy. A learning curve has been observed in terms of blood loss during donor hepatectomy.
These results indicate that our approach toward the selection and management of donors was appropriate. Because of the use of meticulous operative techniques, blood loss could also be minimized.