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Reuters Health Information (2007-06-28): Living liver donor complications seen as underreported

Professional Development

Living liver donor complications seen as underreported

Last Updated: 2007-06-28 12:33:30 -0400 (Reuters Health)

RIO DE JANEIRO (Reuters Health) - At the 13th Annual International Congress of the International Liver Transplantation Society, experts debated donor morbidity and mortality associated with live liver donation. From the presentations, it was clear that these donations are associated with a considerable donor mortality and morbidity, with fatalities and complications remaining unreported by many transplantation centers.

"Live donation is potentially morbid," said Dr. Timothy Pruett, of the University of Virginia Health System, Charlottesville. Rehospitalization occurs in a significant number of people, with about 40% of people having some sort of complication and a few dying following donation, according to estimates he cited.

"Exact data on morbidity and mortality are not known," said Dr. Burkhardt Ringe, of the Center for Liver, Biliary and Pancreas Disease at Drexel University College of Medicine in Philadelphia, Pennsylvania. Despite four independent reviews published in 2006, there are no accurate data on the number of donor deaths.

Dr. Ringe and his group reviewed the medical literature published since 1989, ranging from anecdotal reports to sophisticated surveys, in an attempt to update the worldwide living donor mortality rate. Their goal was to assess the accuracy of the information as they assigned certainty levels to each source identified, ranging from direct reporting of fatalities by the center to indirect publication by an author not involved in the care, and information based on personal or verbal communication.

At the congress, Dr. Ringe reported a donor death at his center that has not been reflected in the latest mortality reports.

It is estimated that more than 10,000 living donor transplants having been performed worldwide, and that the donor death rate ranges from 0.1% to 0.3%.

"I think it is important to report every donor mortality, regardless of whether it occurs early or late," said Dr. Ringe. "To maintain truly informed consent and public confidence in the procedure, it is imperative that all deaths of living donors be reported by the transplant program where the fatality occurred."

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