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Semin Liver Dis 2018; 38(02): 134-144
DOI: 10.1055/s-0038-1636932
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Surgical Complications after Right Hepatectomy for Live Liver Donation: Largest Single-Center Western World Experience

Andre Gorgen
1   Multi-Organ Transplant Unit, Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
2   Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
,
Nicolas Goldaracena
1   Multi-Organ Transplant Unit, Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
2   Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
,
Wei Zhang
1   Multi-Organ Transplant Unit, Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
2   Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
,
Roizar Rosales
1   Multi-Organ Transplant Unit, Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
2   Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
,
Anand Ghanekar
1   Multi-Organ Transplant Unit, Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
2   Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
,
Les Lilly
1   Multi-Organ Transplant Unit, Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
3   Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
,
Mark Cattral
1   Multi-Organ Transplant Unit, Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
2   Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
,
Paul Greig
1   Multi-Organ Transplant Unit, Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
2   Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
,
Stuart McCluskey
4   Department of Anesthesia, University Health Network, University of Toronto, Toronto, Ontario, Canada
,
Ian McGilvray
1   Multi-Organ Transplant Unit, Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
2   Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
,
Nazia Selzner
1   Multi-Organ Transplant Unit, Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
3   Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
,
Mamatha Bhat
1   Multi-Organ Transplant Unit, Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
3   Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
,
Markus Selzner
1   Multi-Organ Transplant Unit, Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
2   Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
,
Gary Levy
1   Multi-Organ Transplant Unit, Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
3   Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
,
David Grant
1   Multi-Organ Transplant Unit, Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
2   Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
,
Gonzalo Sapisochin
1   Multi-Organ Transplant Unit, Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
2   Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
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Publikationsdatum:
22. März 2018 (online)

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Abstract

The authors assessed the incidence, management, and risk factors for postoperative complications after right lobe (RL) live donor hepatectomy in a high-volume center in North America. All donors undergoing an RL live donor hepatectomy between 2000 and 2017 at our institution were included. The primary outcome was the development of complications (both medical and surgical). Predictors of postoperative complications were determined by logistic regression. A total of 587 patients underwent RL live donor hepatectomy. Among those, 187 postoperative complications were diagnosed in 141 (24%) patients. One patient had >90-day morbidity, and there were no donor deaths. Overall complications were significantly higher in the first era, 2000 to 2008 (81 [57.4%]) versus the second era, 2009 to 2017 (60 [42.6%]) (p = 0.01). On multivariate analysis, the only predictor of postoperative complications was the center volume of RL live donor hepatectomy in the previous 12 months with an odds ratio of 0.97 (95% confidence interval: 0.95–0.99). In conclusion, increasing center volume is associated with lower rates of postoperative complications after RL living liver donation.

Keywords

living donor liver transplantation - LDLT - donor safety - right lobe - surgical complication

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