One-year morbidity after donor right hepatectomy

Dianne LaPointe Rudow, Robert S. Brown, Jean C. Emond, Douglas Marratta, Sarah Bellemare, Milan Kinkhabwala

Research output: Contribution to journalArticle

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Abstract

Live donors are becoming an increasingly important source of donor organs in liver transplantation; however, long-term functional aspects of recovery from donor right hepatectomy are unknown. We analyzed donor outcomes at 1-year follow-up. We performed a single-center retrospective analysis of 70 right hepatectomy donors. Six-week and 1-year postoperative follow-up results were compared to preoperative baseline values. Ultrasonography was performed in all donors at 6 weeks and as clinically indicated. All donors were alive and well at the end of the study period. Of 66 right hepatic donors, only 22 (32%) were fully compliant with a 1-year follow-up visit. All those not compliant were contacted by phone. All complications except 1 (late finding of portal vein thrombosis) occurred in the perioperative (90-day) period. The incidence of bile leak was 4.3%, incisional hernia 20%, and autologous transfusion 1.0%. There were no aborted procedures. In those compliant with full 1-year follow-up, total bilirubin, aspartate aminotransferase, and alanine aminotransferase were normal in 97%. A total of 5 donors were noted to have persistence of asymptomatic thrombocytopenia beyond the perioperative period (90 days). These were investigated with Doppler sonography. Sonography was unremarkable in 3 of the 5, while 2 had abnormal findings: splenomegaly alone in 1, and splenomegaly with portal vein thrombosis in the other. Magnetic resonance angiography was performed in both, and the patient with portal vein thrombosis underwent endoscopy, which failed to reveal varices. Neither has clinical portal hypertension. Both remain asymptomatic albeit with stable thrombocytopenia. In conclusion, the majority of complications after donor right hepatectomy occur in the perioperative period. Later findings may include asymptomatic thrombocytopenia, with an incidence possibly as high as 23%, though the significance of this finding remains uncertain. Larger-scale studies are needed to confirm the true incidence and clinical significance of persistent thrombocytopenia in the donor hepatectomy population. Strategies to improve compliance with 1-year follow-up visits need to be developed.

Original languageEnglish (US)
Pages (from-to)1428-1431
Number of pages4
JournalLiver Transplantation
Volume10
Issue number11
DOIs
StatePublished - Nov 2004
Externally publishedYes

Fingerprint

Hepatectomy
Tissue Donors
Morbidity
Thrombocytopenia
Portal Vein
Perioperative Period
Thrombosis
Splenomegaly
Ultrasonography
Incidence
Doppler Ultrasonography
Magnetic Resonance Angiography
Varicose Veins
Portal Hypertension
Aspartate Aminotransferases
Alanine Transaminase
Bilirubin
Bile
Liver Transplantation
Endoscopy

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

LaPointe Rudow, D., Brown, R. S., Emond, J. C., Marratta, D., Bellemare, S., & Kinkhabwala, M. (2004). One-year morbidity after donor right hepatectomy. Liver Transplantation, 10(11), 1428-1431. https://doi.org/10.1002/lt.20280

One-year morbidity after donor right hepatectomy. / LaPointe Rudow, Dianne; Brown, Robert S.; Emond, Jean C.; Marratta, Douglas; Bellemare, Sarah; Kinkhabwala, Milan.

In: Liver Transplantation, Vol. 10, No. 11, 11.2004, p. 1428-1431.

Research output: Contribution to journalArticle

LaPointe Rudow, D, Brown, RS, Emond, JC, Marratta, D, Bellemare, S & Kinkhabwala, M 2004, 'One-year morbidity after donor right hepatectomy', Liver Transplantation, vol. 10, no. 11, pp. 1428-1431. https://doi.org/10.1002/lt.20280
LaPointe Rudow, Dianne ; Brown, Robert S. ; Emond, Jean C. ; Marratta, Douglas ; Bellemare, Sarah ; Kinkhabwala, Milan. / One-year morbidity after donor right hepatectomy. In: Liver Transplantation. 2004 ; Vol. 10, No. 11. pp. 1428-1431.
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abstract = "Live donors are becoming an increasingly important source of donor organs in liver transplantation; however, long-term functional aspects of recovery from donor right hepatectomy are unknown. We analyzed donor outcomes at 1-year follow-up. We performed a single-center retrospective analysis of 70 right hepatectomy donors. Six-week and 1-year postoperative follow-up results were compared to preoperative baseline values. Ultrasonography was performed in all donors at 6 weeks and as clinically indicated. All donors were alive and well at the end of the study period. Of 66 right hepatic donors, only 22 (32{\%}) were fully compliant with a 1-year follow-up visit. All those not compliant were contacted by phone. All complications except 1 (late finding of portal vein thrombosis) occurred in the perioperative (90-day) period. The incidence of bile leak was 4.3{\%}, incisional hernia 20{\%}, and autologous transfusion 1.0{\%}. There were no aborted procedures. In those compliant with full 1-year follow-up, total bilirubin, aspartate aminotransferase, and alanine aminotransferase were normal in 97{\%}. A total of 5 donors were noted to have persistence of asymptomatic thrombocytopenia beyond the perioperative period (90 days). These were investigated with Doppler sonography. Sonography was unremarkable in 3 of the 5, while 2 had abnormal findings: splenomegaly alone in 1, and splenomegaly with portal vein thrombosis in the other. Magnetic resonance angiography was performed in both, and the patient with portal vein thrombosis underwent endoscopy, which failed to reveal varices. Neither has clinical portal hypertension. Both remain asymptomatic albeit with stable thrombocytopenia. In conclusion, the majority of complications after donor right hepatectomy occur in the perioperative period. Later findings may include asymptomatic thrombocytopenia, with an incidence possibly as high as 23{\%}, though the significance of this finding remains uncertain. Larger-scale studies are needed to confirm the true incidence and clinical significance of persistent thrombocytopenia in the donor hepatectomy population. Strategies to improve compliance with 1-year follow-up visits need to be developed.",
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