Complications and long-term outcome of living liver donors: a survey of 1,508 cases in five Asian centers

Abstract

A multicenter survey was conducted regarding the safety and outcome of living liver donors in Asia. Five Asian liver transplant centers reported a total of 1,508 living donor liver transplantations (LDLT) performed between January 1990 and December 2001. The recipients consisted of 766 adults and 742 children. The graft types were left lateral or extended left lateral segment in 605, left lobe in 334, right lobe or right lateral sector in 561, and not classified in eight cases. The donor blood loss was less than 1,000 mL in 94.1% of the cases, and 0.53% of the donors received banked blood transfusion. The overall donor complication rate was 15.8%, and 1.1% of donors underwent reoperation. The complication rate was higher in right lobe (28%) than in left lateral segment (9.3%) or left lobe (7.5%) donors. In particular, right lobe donors had more serious complications such as cholestasis (7.3%), bile leakage (6.1%), biliary stricture (1.1%), portal vein thrombosis (0.5%), intra-abdominal bleeding (0.5%), and pulmonary embolism (0.5%). There was no hospital mortality, but there was one late donor death 3 years after operation. Long-term follow-up beyond 3 months was available in 15.1% of the donors only. The data from the multicenter study set the standard for the safety of living liver donors in high-volume liver transplant centers in Asia and provide further justification for the continued application of LDLT in the face of the critical organ shortage in Asia. The long-term outcome of liver donation, however, remains unknown, and transplant centers should continue their follow-up of donors.