Abstract
Donor safety is the major concern in living donor liver transplantation (LDLT), and a constant aware of postoperative morbidity should be emphasized. Between March 2002 and May 2011 we performed 435 liver transplantations at an our center, one hundred forty eight with living donors. Among them left lobectomy or left lateral resections were conducted in 68 cases. Symptoms of gastric obstruction were recognized in 3 out of 68 patients that underwent left lateral resection (4.4%). The patients were readmitted because of severe symptoms of vomiting and abdominal pain. An upper endoscopy was performed and revealed pyloroantral obstruction due to gastric volvulus (GV). Endoscopic therapy correction was successfully performed in all patients. Reviewing the literature, one article has reported GV in 13 out of 115 donors (11.3%), all patients were submitted to a left resection. The mechanisms underlying this complication, in LDLT scenario, have not been fully elucidated. Nevertheless, clinicians should be aware of this possible association, which could make the diagnosis of GV more likely if a living donor comes back with typical symptoms.
Highlights
Living donor liver transplantation (LDLT) has emerged as an essential surgical approach to minimize mortality of patients awaiting transplantation
Clinicians should be aware of this possible association, which could make the diagnosis of gastric volvulus (GV) more likely if a living donor comes back with typical symptoms
Therapeutic endoscopy therapy correction was successfully performed in all three patients without recurrence
Summary
Living donor liver transplantation (LDLT) has emerged as an essential surgical approach to minimize mortality of patients awaiting transplantation. Donor safety is the most important issue related to LDLT, and the selection of a donor for LDLT is one of the most dedicated features of this procedure [1,2]. Postoperative follow-up complication must be as thorough as the extensive preoperative selection evaluation. The overall donor complication rates, ranges between 13% to 75% [3], according to the classification proposed by Clavien-Dindo [4]. The main reasons are linked to wound infections and bile leaks. There is only one publication addressing the issue of gastric volvulus after left lateral resection for LDLT [5]
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