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research
Complications of right lobe living donor liver transplantation
Authors
Barr
Bogin
+53 more
Broelsch
Bronsther
Campsen
Chan
Chan
Clavien
Cronin
Dahm
Demetris
Dindo
Edward Gray
Eghtesad
Fan
Freise
Gali
Ghobrial
Gondolesi
Gruttadauria
Gruttadauria
Hwang
Hwang
James W. Marsh
Khalaf
Kokudo
Liu
Lo
Malago
Maluf
Marcos
Marcos
Middleton
Morioka
Nadalin
Olthoff
Pomposelli
Pruett
Roberta Ness
Shah
Shah
Shah
Starzl
Starzl
Starzl
Strong
Sugawara
Tamura
Thomas E. Starzl
Todo
Todo
Trotter
Wachs
Yamaoka
Yi
Publication date
1 January 2009
Publisher
'Elsevier BV'
Doi
Cite
View
on
PubMed
Abstract
Background/Aims: Right lobar living donor liver transplantation (LDLT) has been controversial because of donor deaths and widely variable reports of recipient and donor morbidity. Our aims were to ensure full disclosure to donors and recipients of the risks and benefits of this procedure in a large University center and to help explain reporting inconsistencies. Methods: The Clavien 5-tier grading system was applied retrospectively in 121 consecutive adult right lobe recipients and their donors. The incidence was determined of potentially (Grade III), actually (Grade IV), or ultimately fatal (Grade V) complications during the first post-transplant year. When patients had more than one complication, only the seminal one was counted, or the most serious one if complications occurred contemporaneously. Results: One year recipient/graft survival was 91%/84%. Within the year, 80 (66%) of the 121 recipients had Grade III (n = 54) Grade IV (n = 16), or Grade V (n = 10) complications. The complications involved the graft's biliary tract (42% incidence), graft vasculature (15%), or non-graft locations (9%). Complications during the first year did not decline with increased team experience, and adversely affected survival out to 5 years. All 121 donors survive. However, 13 donors (10.7%) had Grade III (n = 9) or IV (n = 4) complications of which five were graft-related. Conclusions: Despite the satisfactory recipient and graft survival at our and selected other institutions, and although we have not had a donor mortality to date, the role of right lobar LDLT is not clear because of the recipient morbidity and risk to the donors. © 2009 European Association for the Study of the Liver
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