Minimal blood loss living donor hepatectomy

Background. Donor hepatectomy with maximal safety while preserving graft vi ability is of principal concern in living donor liver transplantation. Ther e are compelling reasons for avoiding blood transfusion, even with autologo us blood, to avoid the potential risks it imposes on healthy donors. This s tudy aims to describe the surgical technique and clinical outcomes of livin g donor hepatectomy with minimal blood loss requiring no blood transfusion. Methods. Donor hepatectomy was performed in 30 living donors according to a detailed preoperative imaging study of the vascular and biliary anatomy. L iver parenchymal transection was carried out with strict adherence to a met iculous surgical technique without vascular inflow occlusion to either side of the liver. Pre-, intra-, and postoperative data were gathered, and fact ors related to blood loss were analyzed retrospectively. Results. The intraoperative blood loss ranged from 20 to 300 ml with a mean of 72.0+/-58.9 ml (median, 55 ml), and neither homologous nor autologous b lood transfusion was required in any of the donors intra- and postoperative ly. All 30 donors were discharged with minimal complications, and remain we ll at a mean follow-up of 24 months after donation. Excellent graft viabili ty was verified by the fact that all 30 recipients are alive and well with a few manageable complications, The actual graft and patient survival are b oth 100% at the time of writing. Conclusions. Regardless of the extent of donor hepatectomy, blood loss can and should be kept to a minimum, and living donor hepatectomy without blood transfusion is a realistic objective.