Frequency of Living Donors with Comorbidity for Liver Transplantation: Analysis of 337 Cases

Abstract

Introduction: Living donors for liver transplantation (LT) need to be physically and mentally healthy, but donor candidates sometimes have comorbidities and are forced to evaluate the suitability as donors. We examined the frequency of comorbidities in living liver donors. Patients and methods: Of 337 living donors for LT, except 67 cases with fatty liver, we investigated the preoperative comorbidities and perioperative management in living liver donors. Results: The number of donors with comorbidity was 95 (28%: 95/337), with a median age of 35 (23-57) years, 33 males, and 62 females. Relationships with recipients were 58 mothers, 28 fathers, 2 grandmothers, 2 sons, 5 others. The graft types were 62 lateral segments, 15 left lobes, 6 left lobes with caudate, 6 monosegments, 4 right lobes, and 2 posterior segments. A total of 107 comorbidities was recognized in 95 donors. Twenty-two cases with hepatic comorbidity were positive HBc antibodies, hepatic hemangiomas, drug-induced liver injuries, liver hamartoma, and congenital portosystemic shunt. Extrahepatic comorbidities were plasminogen disorder, obstructive respiratory disorder, lipid metabolism disorder, coagulation factor deficiency, iron deficiency anemia, hypertension, pollinosis, thyroid disease, menstrual abnormalities, postoperative gastrointestinal cancer, metabolic disease, benign ovarian tumor, arrhythmia, pregnancy, and others. We consulted with the department specializing in the comorbidity and closely performed preoperative evaluation and perioperative management according to each comorbidity. No case of complications due to each comorbidity was found. Conclusion: It is important to fully evaluate and determine the suitability of living donor candidates with comorbidities in collaboration with other departments.