Clinical

Zero mortality seen among living liver donors in Japan

Last Updated: 2003-09-02 13:57:36 -0400 (Reuters Health)

NEW YORK (Reuters Health) - In contrast with results in Western countries, no perioperative mortality has occurred among living liver donors in Japan, according to a report published in the August 30th of The Lancet.

Although Japan is one of the leading countries for living donor liver transplantation (LDLT), no national surveys have been conducted to assess the morbidity and mortality of such donors.

To investigate, Dr. Morito Monden, from Osaka University, and colleagues assessed the outcomes of 1841 patients who donated a portion of their liver since the LDLT program began in Japan in November 13, 1989.

None of the patients died around the time of surgery, the authors note. However, 12% of donors did experience postoperative complications.

Donation of the right liver lobe rather than the lateral segment or left lobe graft was tied to a significantly higher risk of complications (p < 0.0001 for both). In line with this finding, right liver lobe donors were hospitalized about 4 days longer, on average, than donors of other segments.

Twenty-three donors required reoperation and the most common reason was for biliary complications. The liver segment donated did not significantly influence the risk of reoperation.

In a related editorial, Dr. Owen S. Surman and Dr. Martin Hertl, from Massachusetts General Hospital in Boston, note that more must be done to ensure the safety of living liver donors.

"In the end we must rely on other avenues for treatment of organ failure, but until such time, careful selection of the donor and keeping in mind that donor safety over-rides benefit for the recipient has to be the 'credo' of the transplant team," the editorialists add.

Lancet 2003;362:674,687-690.