Short-term and long-term outcomes in living donors for liver transplantation: Cohort study

Int J Surg. 2020 Dec:84:147-153. doi: 10.1016/j.ijsu.2020.11.013. Epub 2020 Nov 16.

Abstract

Background: Although perioperative outcomes following donor hepatectomy (DH) have been reported, little is known about the long-term outcomes in living donors of liver transplantation. The aim of this study was to investigate the short-term and long-term outcomes following DH.

Methods: A total of 408 living donors who underwent DH between 1996 and 2019 were analyzed in this retrospective study, focusing on short-term outcomes with respect to the operation period (era) and the graft type, as well as long-term outcomes.

Results: The overall incidence of postoperative complications was 40.4%. These included minor (30.4%), major (10.0%), and biliary (14.0%) complications. Short-term outcomes after DH slightly improved over time, and outcomes did not differ significantly between the graft types. With regards to long-term outcomes, the incidence of surgery-related complications such as keloids, incisional hernias, and mechanical bowel obstructions was 6.6% over a median follow-up of 7.2 years. In addition, some donors developed comorbidities such as lifestyle diseases and cancers during the follow-up period.

Conclusions: Our study confirmed an improvement of perioperative outcomes in living donors. There was no significant association between the graft type and postoperative outcomes. Donors could develop various morbidities during long-term follow-up. Therefore, a careful perioperative management and long-term follow-up should be provided to living donors.

Keywords: Living donor; Living donor liver transplantation; Outcomes.

MeSH terms

  • Adult
  • Female
  • Humans
  • Liver Transplantation / adverse effects*
  • Living Donors*
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Retrospective Studies