Donor safety in living donor liver transplantation: The Korean Organ Transplanta

[Clark]

http://onlinelibrary.wiley.com/doi/10.1002/lt.24778/abstract

Donor safety in living donor liver transplantation: The Korean Organ Transplantation Registry (KOTRY) study
Authors
Jae Geun Lee, Kwang-Woong Lee, Choon Hyuck David Kwon, Chong Woo Chu, Bong-Wan Kim, Dong Lak Choi, Young Kyoung You, Dong-Sik Kim, Yang Won Nah, Koo Jeong Kang, In Soek Choi, Hee Chul Yu, Geun Hong, Ho-Seong Han, Shin Hwang, Myoung Soo Kim
Liver Transplantation
Accepted manuscript online: 21 April 2017
DOI: 10.1002/lt.24778

Abstract
Major concerns about donor safety cause controversy and limit the use of living donor liver transplantation to overcome organ shortages.
The Korean Organ Transplantation Registry established a nationwide organ transplantation registration system in 2014. We reviewed the prospectively collected data of all 832 live liver donors who underwent procedures between April 2014 and December 2015. We allocated the donors to a left lobe group (n=59) and a right lobe group (n=773) and analyzed the relations between graft types and remaining liver volumes and complications (graded using the Clavien five-tier grading system). The median follow-up was 19 months (range, 10-31 months).
During the study period, 553 men and 279 women donated livers and there were no deaths after live liver donation. The overall, biliary, and major complication (Grade ≥ III) rates were 9.3%, 1.7%, and 1.9%, respectively. The graft types and remaining liver volume were associated with significantly different overall, biliary, and major complication rates. Of the 16 cases with major complications, nine (56.3%) involved biliary complications [two biliary strictures (16.5%) and seven bile leakages (43.8%)]. Among the 832 donors, the mean AST, ALT, and total bilirubin levels were 23.9 ± 8.1 IU/L, 20.9 ± 11.3 IU/L, and 0.8 ± 0.4 mg/dL, respectively, 6 months after liver donation.
In conclusion, biliary complications were the most common types of major morbidity in live liver donors. Donor hepatectomy can be performed successfully with minimal and easily controlled complications. . Our study shows that prospective, nationwide cohort data provide an important means of investigating the safety in live liver donation.