This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (194)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Surgery, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

Sheung-Tat Fan, MS, MD, FRCS(Glasg and Edin); Chung-Mau Lo, MS, FRACS, FRCS(Edin); Chi-Leung Liu, MBBS, FRCS(Edin); Boon-Hun Yong, MBBS, MRCP; John Ka-Fat Chan, MBBS, DMRD, FRCR; Irene Oi-Lin Ng, MD, FRCPath

Arch Surg. 2000;135:336-340.

Hypothesis  Right lobe donation was advocated for adult-to-adult live donor liver transplantation but the safety of the donor is still a major concern. We hypothesize that right lobe donation is safe if the lowest limit of volume of liver remnant that can support donor survival is known.

Design  Retrospective analysis of data collected prospectively.

Setting  Tertiary hepatobiliary surgery referral center.

Patients  Twenty-two live donors involved in adult-to-adult right lobe liver transplantation from May 1996 to June 1999.

Interventions  The right lobe grafts were obtained by transecting the liver on the left side of the middle hepatic vein. Liver transection was performed by using an ultrasonic dissector, without using the Pringle maneuver. The left lobe volume was measured by computed tomographic volumetry and the ratio of left lobe volume to the total liver volume was calculated.

Main Outcome Measures  Hospital mortality rate and complication rate.

Results  The median blood loss was 719 mL (range, 200-1600 mL). Only one donor, who had thalassemia, received 1 U of homologous blood transfusion. Postoperative complications included wound infection, incision hernia, and cholestasis in 1 donor whose liver showed 20% fatty change and who had a left lobe–total liver volume of 0.34. Another donor with 15% fatty change in the liver and a left lobe–total liver volume ratio of 0.27 developed prolonged cholestasis. Two other donors with left lobe–total liver volume ratios of 0.27 but with mild steatosis (<5%) did not develop postoperative cholestasis. Postoperative complications also included 1 case of biliary stricture and 1 case of small bowel obstruction. Both complications were adequately treated. There was no donor mortality. All donors are well and have returned to their previous occupations.

Conclusion  Live donation of right lobe graft for adult-to-adult liver transplantation is safe provided that the residual liver volume exceeds 30% of the total liver volume and the liver itself is normal or only mildly affected by steatosis.

From the Center of Liver Diseases, Departments of Surgery (Drs Fan, Lo, and Liu), Anesthesiology (Dr Yong), Diagnostic Radiology (Dr Chan), and Pathology (Dr Ng), The University of Hong Kong, Hong Kong.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Liver Transplantation for Hepatocellular Carcinoma in Asia
de Villa and Lo
The Oncologist 2007;12:1321-1331.
ABSTRACT | FULL TEXT  

Gadobenate dimeglumine-enhanced liver MRI as the sole preoperative imaging technique: a prospective study of living liver donors.
An et al.
Am. J. Roentgenol. 2006;187:1223-1233.
ABSTRACT | FULL TEXT  

Living Donor Right Liver Lobes: Preoperative CT Volumetric Measurement for Calculation of Intraoperative Weight and Volume
Lemke et al.
Radiology 2006;240:736-742.
ABSTRACT | FULL TEXT  

Living donor liver transplantation: present status and recent advances
Sugawara and Makuuchi
Br Med Bull 2006;75-76:15-28.
ABSTRACT | FULL TEXT  

Preoperative MRI of Potential Living-Donor-Related Liver Transplantation Using a Single Dose of Gadobenate Dimeglumine
Lim et al.
Am. J. Roentgenol. 2005;185:424-431.
ABSTRACT | FULL TEXT  

Liver Segmentation in Living Liver Transplant Donors: Comparison of Semiautomatic and Manual Methods
Hermoye et al.
Radiology 2005;234:171-178.
ABSTRACT | FULL TEXT  

Defining Intrahepatic Biliary Anatomy in Living Liver Transplant Donor Candidates at Mangafodipir Trisodium-enhanced MR Cholangiography versus Conventional T2-weighted MR Cholangiography
Lee et al.
Radiology 2004;233:659-666.
ABSTRACT | FULL TEXT  

Preoperative Hepatic Vascular Evaluation with CT and MR Angiography: Implications for Surgery
Sahani et al.
RadioGraphics 2004;24:1367-1380.
ABSTRACT | FULL TEXT  

Living Donor Liver Transplantation: Complications in Donors and Interventional Management
Lee et al.
Radiology 2004;230:443-449.
ABSTRACT | FULL TEXT  

One Thousand Fifty-Six Hepatectomies Without Mortality in 8 Years
Imamura et al.
Arch Surg 2003;138:1198-1206.
ABSTRACT | FULL TEXT  

Value of Live Donor Liver Transplantation Experience in Major Hepatectomy for Hepatocellular Carcinoma
Chan et al.
Arch Surg 2003;138:265-271.
ABSTRACT | FULL TEXT  

Blood-Transfusion Requirements and Blood Salvage in Donors Undergoing Right Hepatectomy for Living Related Liver Transplantation
Lutz et al.
Anesth. Analg. 2003;96:351-355.
ABSTRACT | FULL TEXT  

Adult-to-Adult Transplantation of the Right Hepatic Lobe from a Living Donor
Trotter et al.
NEJM 2002;346:1074-1082.
FULL TEXT  

MR Imaging as the Sole Preoperative Imaging Modality for Right Hepatectomy: A Prospective Study of Living Adult-to-Adult Liver Donor Candidates
Lee et al.
Am. J. Roentgenol. 2001;176:1475-1482.
ABSTRACT | FULL TEXT  

Right Lobe Living Donor Liver Transplantation: Preoperative Evaluation of the Donor with MR Imaging
Fulcher et al.
Am. J. Roentgenol. 2001;176:1483-1491.
ABSTRACT | FULL TEXT  

Live Donor Adult Liver Transplantation Using Right Lobe Grafts: Donor Evaluation and Surgical Outcome
Pomfret et al.
Arch Surg 2001;136:425-433.
ABSTRACT | FULL TEXT  

Volumetric Mangafodipir Trisodium-Enhanced Cholangiography to Define Intrahepatic Biliary Anatomy
Lee et al.
Am. J. Roentgenol. 2001;176:906-908.
FULL TEXT