Abstract:
Living-donor liver transplantation (LDLT) is an excellent option for patients with
end-stage liver disease in situations of donor shortage. The aims of this study were to
evaluate our experience with left-lobe donor hepatectomy for LDLT and to grade
postoperative complications using the 5-tier Clavien classification system. Data from
medical records of 60 adult living liver donors (30 men, 30 women) who underwent
left-lobe hepatectomy between November 2006 and April 2012 were reviewed. The median
donor age was 31.7 8.9 (range, 19 – 63) years. Sixteen complications were observed in
12/60 (20%) donors. Complications developed in 6/15 (40%) donors who underwent left
hepatectomy and in 6/45 (13.3%) donors who underwent left lateral segmentectomy. Seven
of 16 (43.7%) complications were Grade I and 2 (12.5%) were Grade II. Major
complications consisted of 4 (25%) Grade IIIa and 3 (18.7%) Grade IIIb complications; no
Grade IVb or V complications occurred. The most common complication was biliary,
occurring in 7 (11.6%) donors and comprising 43.7% of all 16 complications. The mean
duration of follow-up was 30 7.1 (range, 2–58) months. No donor mortality occurred.
Left-lobe donor hepatectomy for LDLT, which does not benefit the completely healthy
donor, was performed safely and with low complication rates, but carries the risk of
morbidity. Low morbidity rates following living-donor hepatectomy can be expected when
surgical and clinical monitoring and follow-up are adequate and the surgeon has gained
increased experience.
