Life-threatening or nearly life-threatening complications in living

Abstract

ObjectiveTo determine the relationship between a transplant center's experience and life-threatening or nearly life-threatening complications during living donor hepatectomy (LDH).

MethodsThe medical records of 1140 patients who underwent LDH were analyzed. To determine the relationship between life-threatening complications and a transplant center's experience, the following comparisons between LDH cases were performed: first 100 vs subsequent 100; first 100 vs subsequent 1040; first 200 vs subsequent 940; right hepatectomy vs left hepatectomy; and first 5years of experience vs subsequent 5years.

ResultsA total of 36 life-threatening or nearly life-threatening complications developed in 34 of 1140 (2.98%) healthy individuals undergoing LDH. Of these, 5 occurred intraoperatively, 26 within 1month, and 5 beyond 1month. The most common complications were biliary problems and postoperative bleeding. None of the donors died at follow-up. One donor underwent deceased donor liver transplantation (DDLT) for severe hepatic failure. Only 2 comparisons were significantly different with regard to life-threatening complications: the first 100 vs the subsequent 1040 (P=.03) and the first 200 vs the subsequent 940 (P=.01).

ConclusionThis study indicates that the incidence of life-threatening or nearly life-threatening complications are reduced by increased center experience (>200 LDHs).

C1 [Akbulut, Sami] Inonu Univ, Fac Med, Dept Surg, Malatya, Turkey.

[Akbulut, Sami] Inonu Univ, Fac Med, Liver Transplant Inst, Malatya, Turkey.