Low residual volume in donors for living donor liver transplantation, donor safety

Abstract

Background Liver transplantation is the treatment of choice for cirrhotic patients, decompensated disease, fulminant hepatitis, and hepatocellular carcinomas within Milan criteria. In the past decades, liver transplantation has progressed from an experimental approach with a very high mortality to an almost ordinary procedure with good short-term and long-term survival rates. Aim The aim of the present study was to investigate the relationship between donor recovery, postoperative complications, and the volume of remnant liver. Patients and methods This is a retrospective observational cohort study that included 63 liver donors operated upon in Ain Shams Specialized Hospital and in Egypt Air Hospital from January 2016 to January 2018, who were divided into in two groups: group A with residual volume with Middle Hepatic Vein (MHV) ranging from 33 to 35% with 19 donors in it, and group B with residual volume with MHV ranging from 35 to 38% with 44 donors in it. Results There was no significant difference between the two groups regarding age, sex, steatosis, and operation center. Comparing the two groups according to postoperative bilirubin resulted in no significant difference between the two groups. Moreover, comparing complications [grade according to modified Clavien scale of post-operative complications (P=0.966), as well as type ‘respiratory, cardiac, vascular, wound infection, intraperitoneal hematoma, biliary complications, pancreatitis, hernia, and multiple complications’ (P=0.499)] did not result in any statistical difference between the two groups in spite of the mild complications. Conclusion Low residual volume up to 33% in donors of living-donor liver transplantation does not affect their safety, as there is no difference in the increase in the recovery period. Moreover, there is no significant difference in postoperative complications rate regarding donors with residual volume more than 35%, and at the same time, increase the availability of liver graft for patients in need for transplantation.