Outcomes of Left-Lobe Donor Hepatectomy for Living-Donor Liver Transplantation: A Single-Center Experience

Abstract

Living-donor liver transplantation (LDLT) is an excellent option for patients with end-stage liver disease in situations of donor shortage. The aims of this study were to evaluate our experience with left-lobe donor hepatectomy for LDLT and to grade postoperative complications using the 5-tier Clavien classification system. Data from medical records of 60 adult living liver donors (30 men, 30 women) who underwent left-lobe hepatectomy between November 2006 and April 2012 were reviewed. The median donor age was 31.7 ± 8.9 (range, 19–63) years. Sixteen complications were observed in 12/60 (20%) donors. Complications developed in 6/15 (40%) donors who underwent left hepatectomy and in 6/45 (13.3%) donors who underwent left lateral segmentectomy. Seven of 16 (43.7%) complications were Grade I and 2 (12.5%) were Grade II. Major complications consisted of 4 (25%) Grade IIIa and 3 (18.7%) Grade IIIb complications; no Grade IVb or V complications occurred. The most common complication was biliary, occurring in 7 (11.6%) donors and comprising 43.7% of all 16 complications. The mean duration of follow-up was 30 ± 7.1 (range, 2–58) months. No donor mortality occurred. Left-lobe donor hepatectomy for LDLT, which does not benefit the completely healthy donor, was performed safely and with low complication rates, but carries the risk of morbidity. Low morbidity rates following living-donor hepatectomy can be expected when surgical and clinical monitoring and follow-up are adequate and the surgeon has gained increased experience.