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Complications of right lobe living donor liver transplantation

Marsh, JW and Gray, E and Ness, R and Starzl, TE (2009) Complications of right lobe living donor liver transplantation. Journal of Hepatology, 51 (4). 715 - 724. ISSN 0168-8278

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Abstract

Background/Aims: Right lobar living donor liver transplantation (LDLT) has been controversial because of donor deaths and widely variable reports of recipient and donor morbidity. Our aims were to ensure full disclosure to donors and recipients of the risks and benefits of this procedure in a large University center and to help explain reporting inconsistencies. Methods: The Clavien 5-tier grading system was applied retrospectively in 121 consecutive adult right lobe recipients and their donors. The incidence was determined of potentially (Grade III), actually (Grade IV), or ultimately fatal (Grade V) complications during the first post-transplant year. When patients had more than one complication, only the seminal one was counted, or the most serious one if complications occurred contemporaneously. Results: One year recipient/graft survival was 91%/84%. Within the year, 80 (66%) of the 121 recipients had Grade III (n = 54) Grade IV (n = 16), or Grade V (n = 10) complications. The complications involved the graft's biliary tract (42% incidence), graft vasculature (15%), or non-graft locations (9%). Complications during the first year did not decline with increased team experience, and adversely affected survival out to 5 years. All 121 donors survive. However, 13 donors (10.7%) had Grade III (n = 9) or IV (n = 4) complications of which five were graft-related. Conclusions: Despite the satisfactory recipient and graft survival at our and selected other institutions, and although we have not had a donor mortality to date, the role of right lobar LDLT is not clear because of the recipient morbidity and risk to the donors. © 2009 European Association for the Study of the Liver.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Marsh, JW
Gray, E
Ness, R
Starzl, TEtes11@pitt.eduTES11
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 October 2009
Date Type: Publication
Journal or Publication Title: Journal of Hepatology
Volume: 51
Number: 4
Page Range: 715 - 724
DOI or Unique Handle: 10.1016/j.jhep.2009.04.023
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0168-8278
Other ID: uls-drl:31735062121615, Starzl CV No. 2255
Date Deposited: 08 Apr 2010 17:38
Last Modified: 13 Oct 2017 21:55
URI: http://d-scholarship.pitt.edu/id/eprint/5641

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