COMPLICATIONS IN 100 LIVING-LIVER DONORS

Objective A review of 100 living-liver donors was performed to evaluat e the perisurgical complications of the procedure and thus to help qua ntify the risks to the donor. Summary Background Data Despite the adva ntages of living-donor liver transplantation (LDLT), the procedure has received criticism for the risk it imposes on healthy persons. A pauc ity of data exists regarding the complications and relative safety of the procedure. Methods One hundred LDLTs performed between November 19 89 and November 1996 were reviewed. Donor data were obtained by chart review, anesthesia records, and the computerized hospital data base. P atient variables were compared by Fisher's exact test and the Student' s t test. Results There were 57 women and 43 men with a median age of 29. Donors were divided into two groups: group A (first 50 donors), an d group B (last 50 donors). There were 91 left lateral segments and 9 left lobes. There were no deaths. Fourteen major complications occurre d in 13 patients; 9 occurred in group A and 5 in group B. Biliary comp lications consisted of five bile duct injuries (group A = 4, group B = 1) and two cut edge bile leaks. Complications were more common in lef t lobe resections (55%) than in left lateral segment grafts (10%). Min or complications occurred in 20% of patients. A significant reduction in overall complications (major and minor) was observed between the gr oups (group A, n = 24 [45%] vs. group B, n = 10 [20%]). In addition, s urgical time and hospital stay were both significantly reduced. Conclu sions Although the procedure is safe, many LDLT donors have a perisurg ical complication. Surgical experience and technical modifications hav e resulted in a significant reduction in these complications, however. To minimize the risks for these healthy donors, LDLT should be perfor med at institutions with extensive experience.