@article{HBSN24518,
author = {Viola Huang and Chao-Long Chen and Yu-Hung Lin and Tsan-Shiun Lin and Chih-Che Lin and Shih-Ho Wang and Chee-Chien Yong and Chih-Yi Chen and Yu-Fan Cheng},
title = {Bilateral proficiency over time leads to reduced donor morbidity in living donor hepatectomy},
journal = {Hepatobiliary Surgery and Nutrition},
volume = {8},
number = {5},
year = {2019},
keywords = {},
abstract = {Background: Although left-lobe donation is considered safer, right-sided donor hepatectomy predominates in adult living donor liver transplantation (LDLT). We hypothesized that bilateral proficiency with donor hepatectomy reduces overall donor complications.
Methods: A retrospective review of 834 adult LDLT donors (221 left lobes) from January 2004 to December 2014 was performed, dividing cases into two eras based on left-graft experience. Donor complications within 6 months were investigated, focusing on graft side and surgical era.
Results: The overall complication rate was 17.6%, and was higher in right-lobe donors. In Era 2, during which left-lobe donation rates were three times higher, total complications decreased (14.7% vs. 20.9%, P=0.02). A significant reduction in postoperative ascites accounted for the lower overall complication rate. The proportion of major biliary complications (BCs) was halved from 62.5% to 25.0%. Right-lobe donor complications also decreased significantly (15.8% vs. 22.9%, P=0.032), demonstrating that it was not only increased left-lobe donations leading to lowered complication rates, but also greater experience with donor hepatectomy in general.
Conclusions: Accumulating experience with bilateral donor hepatectomy leads to decreased donor morbidity and comparable outcomes for right and left lobes, further enhancing the goal of donor safety while balancing recipient needs.},
issn = {2304-389X}, url = {https://hbsn.amegroups.org/article/view/24518}
}