SELECTION OF THE LIVING LIVER-DONOR

Living related liver transplantation offers several advantages in comp arison to transplantation of cadaver organs. To achieve maximal donor safety evaluation, selection criteria and complications of the donor o peration were retrospectively analyzed in living donors of segmental l iver transplants, Seventy-three liver donor candidates were evaluated between October 1991 and June 1994. The median age of 42 mothers and 3 1 fathers was 31 years (range, 19-50 years). The median volume of the left lateral liver lobe comprised 230 ml (100-350 ml). Twenty-four of 73 (33%) donor candidates were not accepted for living donation. Rejec tion was due to unsuitability of the donor's liver as a graft (n=13) o r due to an increased risk for living donation (n=11). Of 35 living do nations performed so far, one was a full left hemihepatectomy and 34 w ere left lateral segmentectomies. The length of the donor operation wa s, on average, 4.3 hr. No heterologous blood was needed. Postoperative complications included death due to pulmonary embolism (n=1), seizure due to a previously undiagnosed ependymoma (n=1), bile duct injury (n =1), incisional hernia necessitating late revision (n=2), and duodenal ulcer (n=2). Long-term follow-up revealed no persistent complications . Using our standardized protocol, 33% of young, presumably healthy do nor candidates were rejected for living donation.