Analysis of Postoperative Liver Function and Complications versus Donor Hepatectomy Type for Living-Related Liver Transplantation. |
Mi Kyung Yang, Mi Sook Gwak, Sung Won Seo, Soo Joo Choi, Tae Soo Hahm, Gaab Soo Kim, Myung Hee Kim |
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. |
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Abstract |
BACKGROUND Although living related liver transplantation (LRLT) has several advantages over cadaveric liver transplantation, there still is considerable debate concerning donor safety. We analyzed postoperative liver function and complications versus type of donor hepatectomy for LRLT. METHODS The charts, anesthetic records and computerized hospital data of 135 consecutive donors registered for LRLT from June 1996 to February 2003 were retrospectively reviewed. Donors were divided into three groups: a left lateral segmentectomy (group LLS; n = 37), a left lobectomy (group LL; n = 8), and a right lobectomy (group RL; n = 90).
Volume and weight of the resected liver, volume of blood loss, fluids and blood administered, surgical time and anesthetic time, duration of hospital stay, complications, and perioperative changes in hemoglobin (Hb), aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and prothrombin time (PT) were investigated. RESULTS No significant differences in donor characteristics, blood loss, and duration of hospital stay were observed. But surgical and anesthetic times in the group RL were longest. The postoperative peak level of AST and ALT in the group LLS were significantly higher than those of the other groups. Postoperative PT and total bilirubin in the group RL were highest. AST, ALT, and PT peaked on the first postoperative day and decreased gradually thereafter. None of the donors experienced a critical complication, including liver failure. CONCLUSIONS Significant differences in surgical time, postoperative liver function and incidence of hyperbilirubinemia were observed according to the type of hepatectomy. But, serious complication occurred in any donor. |
Key Words:
complication; hepatectomy; liver donor; liver function |
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