Retrospective Donor Hepatectomy Results in Living Donor Liver Transplant– A Single-Center Experience

Abstract

Objectives: We aimed to describe our technique and donor selection for donor hepatectomy, review our case series and report our complication rates and outcomes. Materials and Methods: We retrospectively reviewed 41 consecutive donor hepatectomy cases between October 2019 and November 2020 at Yeditepe University, Istanbul, Turkey. Complications were graded according to Clavien-Dindo classification. All cases were performed via laparotomy. Results: Out of 41 donor cases, 38 (92,6%) were right lobe, 2 (4,8%) were left lobe and 1 (2,4%) was left lateral segment donor hepatectomy. Follow up was 9 ±2,2 months (4-16 months). There were 8 (19,5%) complications and all were minor (grade 1 or 2). There were no grade 3 or higher complications. Three (7,3%) of our donors are heterozygous for factor 5 leiden mutation and 4 (9,7%) of our donors had heterozygous prothrombin mutation. Length of stay was average 6.4±1,4 days (range=5-12). Ten donors lost weight with a supervised diet and exercise program. There was one wound complication in this subset of patients. Conclusions: We present our single center donor hepatectomy series with excellent results. We also describe successful weight loss for donors with Body Mass Index (BMI) >30. Donor safety is the most important component of living donor liver transplantation. As donor results continue to improve, living donor liver transplant (LDLT) will continue expand worldwide.

Keywords

• Donor complication
• donor hepatectomy
• liver transplantation
• weight loss

Canlı Vericili Karaciğer Naklinde Retrospektif Donör Hepatektomi Sonuçları- Tek Merkez Deneyimi

Öz

Amaç: Donör hepatektomi tekniğimizi ve donör seçimimizi tanımlamayı, vaka serimizi gözden geçirmeyi, komplikasyon oranlarımızı ve sonuçlarımızı bildirmeyi amaçladık. Gereç ve Yöntemler: Yeditepe Üniversite Hastanesi'nde Ekim 2019 - Kasım 2020 tarihleri arasında 41 ardışık donör hepatektomi olgusunu retrospektif olarak inceledik. Komplikasyonlar Clavien-Dindo sınıflamasına göre derecelendirildi. Tüm olgular laparotomi ile yapıldı. Bulgular: 41 donör olgusunun 38'i (% 92,6) sağ lob, 2'si (% 4,8) sol lob ve 1'i (% 2,4) sol lateral segment donör hepatektomisi idi. Takip süresi 9 ± 2,2 aydı (4-16 ay). Sekiz (% 19,5) komplikasyon vardı ve hepsi minördü (derece 1 veya 2). Derece 3 veya daha yüksek komplikasyon görülmedi. Üç donörde heterozigot Faktör 5 Leiden mutasyonu ve 4 tanesinde heterozigot protrombin mutasyonu vardı. Kalış süresi ortalama 6,4±1,4 gündü (aralık = 5-12). Kontrollü diyet ve egzersiz programı ile 10 donör kilo verdi. Bu hasta alt grubunda bir yara komplikasyonu vardı. Sonuç: Tek merkezli donör hepatektomi serimizi çok iyi sonuçlarla sunuyoruz. Ayrıca BMI( Vücut Kitle İndeksi) > 30 olan donörler için başarılı kilo vermeyi de tanımlıyoruz. Donör güvenliği, canlı donör karaciğer naklinin en önemli bileşenidir. Donör sonuçları iyi oldukça, LDLT(Canlı Vericili Karaciğer Nakli) dünya çapında yaygınlaşmaya devam edecektir.

Anahtar Kelimeler

• Donör komplikasyonu
• donör hepatektomi
• karaciğer transplantasyonu
• kilo kaybı

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