Selection and outcome of the potential live liver donor.

Abstract

A thorough donor evaluation in the living donation process is mandatory to ensure a safe outcome in an otherwise healthy individual. The aim of the current study was to evaluate the reasons for not proceeding to donation and the outcome of live liver donors. A prospective study of potential donors who underwent evaluation and proceeded to surgery from 1 April 2012 to 31 January 2015 was conducted. The process of donor selection, its outcome and peri-operative complications were recorded. A total of 460 donors were evaluated in a stepwise manner for 367 potential recipients. Of the 321 (69.7%) donors not proceeding to donation, the reasons were donor-related in 63.6% and recipient-related in the rest. Common donor-related reasons were: donor reluctance (23.5%), negative liver attenuation index (16.2%), anatomic variations (10.3%), inadequate remnant liver volume (9.8%), unacceptable liver biopsy (8.8%), and inadequate graft volume (5.4%). A majority of donors (82.8%) were turned down early in the (steps 1 and 2) evaluation process. Recipient death was the most common recipient-related reason [n=51 (43.6%)] for not proceeding to donation. There was no donor mortality. The overall complication rate was 19.8% and major complication rate (grade 3 or higher) was 4.4%. A stringent stepwise donor evaluation process leads to early recognition of unsuitable donors and a low complication rate.