Impact of Intra-abdominal Adhesion on Living Donor Right Hepatectomy

[Clark]

http://onlinelibrary.wiley.com/doi/10.1111/ajt.13636/abstract

Impact of Intra-abdominal Adhesion on Living Donor Right Hepatectomy
Seong Hoon Kim*, Seung Duk Lee, Young Kyu Kim andSang-Jae Park
DOI: 10.1111/ajt.13636
American Journal of Transplantation
Accepted Article (Accepted, unedited articles published online and citable. The final edited and typeset version of record will appear in future.)

Abstract
The impact of intra-abdominal adhesion (IAA) on living donor right hepatectomy (LDRH) remains to be clarified. The purpose of this study was to compare both the donor and recipient outcomes of right lobe living donor liver transplantation according to IAA detected intraoperatively. LDRH donors were identified through a prospectively maintained database at the authors’ institution between March 2008 and February 2014. IAA was graded according to Beck et al.(6) LDRH donors with IAA (group A) were matched 1:3 to those without IAA (group B) based on age, gender, body mass index. Perioperative data, complications by the Clavien classification, and the outcomes with at least 12 months follow-up were compared. Thirty-two (7.6%) of a total of 420 LDRH donors had IAA around the liver. Nineteen donors had previous abdominal surgery. LDRH was successfully completed under upper midline laparotomy in all donors. Compared with group B, group A had a longer operative time (270vs.172min; p<0.001), a higher wound complication rate (28.1vs.4.2%; p=0.009), and a longer postoperative stay (10vs.7days; p=0.009). All donors recovered completely to their previous activities. The 1-year graft and recipient survivals of recipients were comparable between two groups. These findings support feasibility and safety of LDRH in patients with IAA.