Near miss complications related to living donor liver transplantation.

INTRODUCTION: Nowadays, LDLT is performed safely through developing surgical techniques and technology. Donor safety is a priority in LDLT. Near-miss events frequency in donors varies from center to center. In this study, we aimed to investigate near miss events of the living liver donors. MATERIAL-METHOD: Between September 2005 and December 2014, 1140 living donors who performed right and left donor hepatectomy, were reviewed retrospectively. Clavien Grade III and Grade IV b complications were considered as near-miss events. Donors were divided into groups. First group is donors who performed in first 5 years and last 5 years, second group is donors who performed first 100 donors and later, third group is who performed right or left hepatectomy. Statistical analysis was performed using Fisher's exact test and p <0.05 was considered significant. RESULTS: Life-threatening complications appeared in 34 of 1140 donor (2.98%). Eleven of them were female, and 23 male. Their mean age and body-mass index were 34,6 year (range from 19 to 62 ) and 24,96 kg/m2 (range from 17,8 to 36,8), respectively. Liver remnant volume of these donor was 33.81% (range from 28 to 47.8%). Right hepatectomy was performed in 975 (85.5%) of the donors and the left hepatectomy was performed in 165 (14.5%) of the donors. The most common near-miss event was biliary problems. Near-miss events were seen in 12 (4.4%) of 271 donor hepatectomy in the first 5 years, 22 (2.57%) of the others in the last 5 years (p> 0.05). Also near-miss events were seen in 7 (7%) of the first 100 donor hepatectomy and in 27 (2.59%) of 1040 that were performed after the first 100 donors (p = 0,02). Near-miss events occurred in 29 (2.97%) of the right donor hepatectomy and 5 (3.03%) of the left donor hepatectomy, respectively. There was no donor mortality. CONCLUSION: Altough LDLT is a life-saving surgery for recipient, it is carried risks of mortality and morbiditiy for completely healty donors. It is not possible to completely prevent the development of complications in the donor, but experience of the transplant center is important to minimalize it. To prevent mortality from Near-miss events, finding the cause and treat appropriately and timely is important.