Anesthetic management of living liver donors

Purpose: Living organ donation is being performed with increasing frequency to overcome the shortage of organs for transplantation. Our experience in the anesthetic management of donors with relevant issues is discussed and c omplications encountered are recorded. Methods: Data were collected retrospectively and analyzed on all 22 left la teral hepatectomies performed at our institution between 1993 to 1997 for t ransplantation. Results Major ethical concern was the risk to the donors and anesthetic iss ues were those of a major abdominal procedure. All except four donors were parents (mother/father). Average blood loss was 805 +/- 479 mi and only two donors required blood transfusion. Mean operative time was 8.2 +/- 1.5 hr, Thoracic epidural analgesia was the most commonly adopted mode of pain rel ief. Average time to return of bower sound postoperatively was 3.1 +/- 1.0 days and was not influenced by the postoperative analgesic technique used. Total duration of hospital stay was 8.4 +/- 1.1 days. Three donors develope d minor postoperative complications atrial fibrillation and retained JP dra in; left lower robe pneumonia; and incisional hernia. All patients recovere d uneventfully. Conclusion: Living organ donors contribute towards decreasing the shortage of organs for transplantation. Minimizing the discomfort associated with th e surgical intervention and providing a complication-free perioperative cou rse will positively influence the continued availability of such donations. On review of the first 22 left lateral hapatectomies performed, we observe d only minor complications. Postoperative pain was a serious problem and th oracic epidural provided satisfactory analgesia.