Predictive Factors of Liver Dysfunction After Right Hemihepatectomy for Adult Living Donor Liver Transplantation
| Autor: | Mohamed Elshoubary, E.A. El-Magd, Mohamed Elsadany, Omar Fathy, Ahmad Mohamed Sultan, Amr M. Yassen, Ahmed Elghawalby, Ahmed Shehta, Tarek Salah, Mohamed Abdulrazek, Mohammed Elmorshedi, Usama Shiha, Ehab E. Abdel-Khalek, Mohamed Abdel Wahab |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Risk medicine.medical_specialty medicine.medical_treatment 030230 surgery Right hemihepatectomy Liver transplantation law.invention 03 medical and health sciences 0302 clinical medicine law Living Donors Medicine Hepatectomy Humans Retrospective Studies Transplantation business.industry Incidence (epidemiology) Liver Diseases Retrospective cohort study Middle Aged Intensive care unit Surgery Liver Transplantation Liver 030211 gastroenterology & hepatology Female Liver dysfunction business Living donor liver transplantation |
| Zdroj: | Transplantation proceedings. 50(4) |
| ISSN: | 1873-2623 |
| Popis: | Background Living liver donors represent a special group of patients. They are healthy individuals who are exposed to a major surgery, in which the dominant liver proportion is extracted as a graft. Of all potential donor-related morbidities, posthepatectomy liver dysfunction (PHLD) is the most significant as it may be directly related to donor mortality. We aimed to review our data of adult living donor liver transplantation (LDLT) utilizing the right hemiliver grafts to determine the incidence and potential predictors for the development of PHLD, defined according to the International Study Group of Liver Surgery. Methods We reviewed the data of all adult living donors who underwent right hemihepatectomy during the period between May 2004 and 2016. Results During the study period, 434 cases underwent right hemihepatectomy for adult LDLT. We divided our cases into 2 groups according to the occurrence of PHLD. A significant lower residual liver volume and percentage were noted in PHLD group. Longer intensive care unit stay and hospital stay, and more postoperative morbidities, were observed in PHLD group. PHLD occurred in 50 cases (11.5%), and most of them were grade A (47 cases [10.8%]). Two cases (0.5%) had grade B requiring diuretic therapy, and 1 case (0.2%) had grade C requiring ultrasound guided tube drainage and surgical exploration finally. Conclusions We should not underestimate the risks of liver donation surgery, especially when utilizing the right hemiliver graft. Donor safety should be ensured by accurate preoperative volumetric assessment of the remnant liver and remnant liver volume limitations must be strictly followed. |
| Databáze: | OpenAIRE |
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