Clinical

Complications common for living liver donors

Last Updated: 2008-09-09 8:30:11 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Thirty-eight percent of right hepatic lobe donors will experience a complication with their procedure, and although in most cases the severity is low grade, a significant proportion of patients will experience a severe or even life-threatening complication, new research shows.

Prior studies attempting to characterize complications in living liver donors have been confined to single centers, according to the report in the August issue of Gastroenterology. The present investigation addressed this limitation by assessing complications among donors enrolled in the nine-center Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL).

A total of 405 donors were accepted for donation between 1998 and 2003, Dr. Rafik M. Ghobrial from the University of California, Los Angeles, and colleagues report. Of these, 393 underwent donation and 12 had an aborted procedure.

Sixty-two percent of donors had no complications, 21% had one, and 17% had two or more (total, 220 complications), the researchers found.

The bulk of complications were minor (48%, grade 1) or caused no lasting disability (47%, grade 2). However, 4% of complications caused lasting disability (grade 3) and 0.8% were fatal (grade 4).

The most common complication, accounting for 12% of cases, was bacterial infection, followed by biliary leak beyond postoperative day 7 (9%), and incisional hernia (6%). Two cases of portal vein thrombosis occurred, including one with inferior vena caval thrombosis.

The hospital readmission rate was 13%, and 4% of donors required multiple readmissions.

The findings from this study "should be used for the education and informed consent process for potential donors," Dr. Ghobrial and colleagues state. "Its greatest value may be realized well before transplantation, when a potential adult recipient is being considered for placement on the deceased donor waiting list and for living donor liver transplantation."

Gastroenterology 2008;135:468-476.