Aborted donor hepatectomies for living donor liver transplantation: A single center experience

Aborted Donor Hepatectomies for Living Donor Liver Transplantation: A Single Center Experience Background: Living donor liver transplantation is a safe method to expand the organ donation pool, in the countries where the cadaveric organ donation rate is limited. In order to prevent postoperative morbidity and mortality, the preoperative evalutation of the potential donors should be made meticulously by a multidisciplinary team. Despite this detailed preperation process, some of the donor operations are aborted due to encountered situations of the donor or the recipient. In this study we analyzed the, terminated donor hepatectomies at different stages of the operation retrospectively. Materials and Methods: In our liver transplantation institute, 1151 liver transplants were performed from March 2002 until the end of September 2013. The 900 of them were living donor liver transplantation and, 250 were cadaveric liver transplantation. In this process, a total of 935 potential donors were taken to operation room and 35 (3.7%) of them, could not be continued due to various reasons. The operations were terminated at different stages. These 35 patients? conditions resulting in abortion of the hepatectomies are analyzed retrospectively. Results: The average age of the patients was 40,6 ± 10,7. Mean BMI was 26,8 ± 4,1, mean hospital stay was 4.6± 1.7 days. Average follow-up of these donor candidates were 19,1 ± 17,7 months. Seven of the cases experienced 1 complication and 1 case experienced 3 complications with a total complication frequency of 10. Wound infection was the most common complication., Only 1 patient required re-operation due to bleeding in the early postoperative period. Postoperative right brachial plexus injury was detected in 1 patient. Among the conditions resulting in abortion of donor hepatectomies, 26 (74.3%) were donor-related, and 8 (22.9%) were recipient-related and 1 of them (2.9%) was for other reason. Histological diagnosis of graft steatosis was the most common condition (40%). Conclusions: In terms of donor safety, abortion of donor hepatectomy should be considered during every stage of the procedure. Especially when the preooperatif evaluation of the potential donors and recipients candidate with the cooperation of a multidisciplinary team (especially radiology team) and organ transplantation team would provide reducing the number of aborted donor hepatectomy cases. Also we think that, increasing surgical experience, will decrease the number of aborted donor hepatectomy cases.