International Journal of Organ Transplantation Medicine (Jul 2010)

Live Donor Partial Hepatectomy for Liver Transplantation: Is There a Learning Curve?

  • R. F. Saidi,
  • N. Elias,
  • D. S. Ko,
  • T. Kawai,
  • J. Markmann,
  • S. Feng,
  • A. B. Cosimi,
  • M. Hertl

Journal volume & issue
Vol. 1, no. 3
pp. 125 – 130

Abstract

Read online

Background: Donor safety is the first priority in living donor liver transplantation (LDLT).Objective: To determine the characteristics and outcome of live liver donors who underwent donor hepatectomyfrom January, 1997 to May, 2007 at Massachusetts General Hospital.Methods: 30 patients underwent LDLT between January, 1997 and May, 2007 at our institution.Results: The type of graft was the right lobe (segments 5-8) in 14, left lobe (segments 2-4) in 4, and left lateralsector (segments 2 and 3) in 12 patients. The mean donor age was 36 (range: 26-57) years. The mean follow-up was 48 (range: 18-120) months. No deaths occurred. Overall, 8 (26.6%) patients experienced a total of 14 post-operative complications. Donor complications based on graft type were as follows: left lateralsector (16.7%), left lobe (25%), and right lobe (35.7%). The experience was divided into two periods 1997-2001 (n=15) and 2002-2007 (n=15). Overall complications during 2 periods were 40% and 13.3%, respectively (p<0.001). The incidence of grade III complication also significantly decreased; 66.7% vs 33.3% (p<0.01).Conclusion: Partial hepatectomy in living donors has a learning curve which appears to be approximately 15 cases. This learning curve is not restricted to the surgeons performing the procedure but involves all aspects of patient care.

Keywords