First Experience in Living Liver Donation From Donors With Sickle Cell Trait

Maren Schulze, MD, PhD, FACS; Ahmed Zidan, MD, PhD; Mark Sturdevant, MD; Sultan Aljudaibi, MD; Mohammad Shagrani, MD; Khalid Bzeizi, MD, FRCP; Saleh Alqahtani, MD; Dieter C. Broering, MD, PhD, FACS, FEBS

doi:10.1097/TXD.0000000000001332

Transplantation Direct (Jun 2022)

First Experience in Living Liver Donation From Donors With Sickle Cell Trait

Maren Schulze, MD, PhD, FACS,
Ahmed Zidan, MD, PhD,
Mark Sturdevant, MD,
Sultan Aljudaibi, MD,
Mohammad Shagrani, MD,
Khalid Bzeizi, MD, FRCP,
Saleh Alqahtani, MD,
Dieter C. Broering, MD, PhD, FACS, FEBS

Affiliations

Maren Schulze, MD, PhD, FACS: 1 Department of Abdominal Transplant and Hepatobiliary Surgery, Organ Transplant Centre of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Ahmed Zidan, MD, PhD: 1 Department of Abdominal Transplant and Hepatobiliary Surgery, Organ Transplant Centre of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Mark Sturdevant, MD: 2 Division of Transplant Surgery, Department of Surgery, University of Washington Medical Centre, Seattle, WA.
Sultan Aljudaibi, MD: 1 Department of Abdominal Transplant and Hepatobiliary Surgery, Organ Transplant Centre of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Mohammad Shagrani, MD: 3 Section of Pediatric Transplant Hepatology, Department of Liver and Small Bowel Health Center, Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Khalid Bzeizi, MD, FRCP: 4 Section of Adult Transplant Hepatology, Department of Liver and Small Bowel Health Center, Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Saleh Alqahtani, MD: 4 Section of Adult Transplant Hepatology, Department of Liver and Small Bowel Health Center, Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Dieter C. Broering, MD, PhD, FACS, FEBS: 1 Department of Abdominal Transplant and Hepatobiliary Surgery, Organ Transplant Centre of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.

DOI: https://doi.org/10.1097/TXD.0000000000001332
Journal volume & issue: Vol. 8, no. 6
p. e1332

Abstract

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Background. Living donor liver transplantation is the main source of organs in the Middle East. Therefore, well balanced criteria are needed to avoid unnecessary exclusion of potential donors, while prioritizing donor safety. We face a high incidence of sickle cell trait (SCT; and disease). Therefore, there is vast experience in general and cardiac surgeries in SCT carriers at our center. After studying their management in detail, we considered accepting SCT carriers as living liver donors, on an exceptional basis. This the first single-center case series of living donor liver transplantation with SCT. Methods. Between January 2012 and September 2021, 20 donors with SCT were reviewed for age, gender, relation to the recipient, hemoglobin, hemoglobin S (HbS), surgical approach, intensive care unit stay, donor and recipients’ complications, and graft and recipient survival. Results. Average age of donors was 28.4 y. Sixteen donated the left lateral segment, 4 the left lobe. Recipients were related children or adults. HbS ranged from 21.2% to 39.9%, being ≥30% in 14 donors. HbS was reduced by phlebotomy or exchange transfusion. We performed 7 open, one laparoscopic, and 12 robotic donor surgeries. Operating room time, blood loss, and intensive care unit stay were comparable to non-SCT donors. There was no SCT-related complication. All donors are alive and free of thromboembolic events. Graft and recipient survival is 100% until follow-up. Conclusion. Our experience should encourage other countries with high incidence of SCT to report their experience with this donor population.

Published in Transplantation Direct

ISSN: 2373-8731 (Online)
Publisher: Wolters Kluwer
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: http://journals.lww.com/transplantationdirect/Pages/default.aspx

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