Donor safety in living donor liver transplantation: The Korean organ transplantation registry study

Jae Geun Lee, Kwang Woong Lee, Choon Hyuck David Kwon, Chong Woo Chu, Bong Wan Kim, Dong Lak Choi, Young Kyoung You, Dong-Sik Kim, Yang Won Nah, Koo Jeong Kang, In Soek Choi, Hee Chul Yu, Geun Hong, Ho Seong Han, Shin Hwang, Myoung Soo Kim

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Major concerns about donor safety cause controversy and limit the use of living donor liver transplantation to overcome organ shortages. The Korean Organ Transplantation Registry established a nationwide organ transplantation registration system in 2014. We reviewed the prospectively collected data of all 832 living liver donors who underwent procedures between April 2014 and December 2015. We allocated the donors to a left lobe group (n = 59) and a right lobe group (n = 773) and analyzed the relations between graft types and remaining liver volumes and complications (graded using the Clavien 5-tier grading system). The median follow-up was 19 months (range, 10-31 months). During the study period, 553 men and 279 women donated livers, and there were no deaths after living liver donation. The overall, biliary, and major complication (grade ≥ III) rates were 9.3%, 1.7%, and 1.9%, respectively. The graft types and remaining liver volume were associated with significantly different overall, biliary, and major complication rates. Of the 16 patients with major complications, 9 (56.3%) involved biliary complications (2 biliary strictures [12.5%] and 7 bile leakages [43.8%]). Among the 832 donors, the mean aspartate transaminase, alanine aminotransferase, and total bilirubin levels were 23.9 ± 8.1 IU/L, 20.9 ± 11.3 IU/L, and 0.8 ± 0.4 mg/dL, respectively, 6 months after liver donation. In conclusion, biliary complications were the most common types of major morbidity in living liver donors. Donor hepatectomy can be performed successfully with minimal and easily controlled complications. Our study shows that prospective, nationwide cohort data provide an important means of investigating the safety in living liver donation. Liver Transplantation 23 999–1006 2017 AASLD.

Original languageEnglish
Pages (from-to)999-1006
Number of pages8
JournalLiver Transplantation
Volume23
Issue number8
DOIs
Publication statusPublished - 2017 Aug 1

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Living Donors
Organ Transplantation
Liver Transplantation
Registries
Tissue Donors
Safety
Liver
Transplants
Hepatectomy
Aspartate Aminotransferases
Alanine Transaminase
Bilirubin
Bile
Pathologic Constriction
Prospective Studies
Morbidity

ASJC Scopus subject areas

  • Surgery
  • Hepatology
  • Transplantation

Cite this

Lee, J. G., Lee, K. W., Kwon, C. H. D., Chu, C. W., Kim, B. W., Choi, D. L., ... Kim, M. S. (2017). Donor safety in living donor liver transplantation: The Korean organ transplantation registry study. Liver Transplantation, 23(8), 999-1006. https://doi.org/10.1002/lt.24778

Donor safety in living donor liver transplantation : The Korean organ transplantation registry study. / Lee, Jae Geun; Lee, Kwang Woong; Kwon, Choon Hyuck David; Chu, Chong Woo; Kim, Bong Wan; Choi, Dong Lak; You, Young Kyoung; Kim, Dong-Sik; Nah, Yang Won; Kang, Koo Jeong; Choi, In Soek; Yu, Hee Chul; Hong, Geun; Han, Ho Seong; Hwang, Shin; Kim, Myoung Soo.

In: Liver Transplantation, Vol. 23, No. 8, 01.08.2017, p. 999-1006.

Research output: Contribution to journalArticle

Lee, JG, Lee, KW, Kwon, CHD, Chu, CW, Kim, BW, Choi, DL, You, YK, Kim, D-S, Nah, YW, Kang, KJ, Choi, IS, Yu, HC, Hong, G, Han, HS, Hwang, S & Kim, MS 2017, 'Donor safety in living donor liver transplantation: The Korean organ transplantation registry study', Liver Transplantation, vol. 23, no. 8, pp. 999-1006. https://doi.org/10.1002/lt.24778
Lee, Jae Geun ; Lee, Kwang Woong ; Kwon, Choon Hyuck David ; Chu, Chong Woo ; Kim, Bong Wan ; Choi, Dong Lak ; You, Young Kyoung ; Kim, Dong-Sik ; Nah, Yang Won ; Kang, Koo Jeong ; Choi, In Soek ; Yu, Hee Chul ; Hong, Geun ; Han, Ho Seong ; Hwang, Shin ; Kim, Myoung Soo. / Donor safety in living donor liver transplantation : The Korean organ transplantation registry study. In: Liver Transplantation. 2017 ; Vol. 23, No. 8. pp. 999-1006.
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abstract = "Major concerns about donor safety cause controversy and limit the use of living donor liver transplantation to overcome organ shortages. The Korean Organ Transplantation Registry established a nationwide organ transplantation registration system in 2014. We reviewed the prospectively collected data of all 832 living liver donors who underwent procedures between April 2014 and December 2015. We allocated the donors to a left lobe group (n = 59) and a right lobe group (n = 773) and analyzed the relations between graft types and remaining liver volumes and complications (graded using the Clavien 5-tier grading system). The median follow-up was 19 months (range, 10-31 months). During the study period, 553 men and 279 women donated livers, and there were no deaths after living liver donation. The overall, biliary, and major complication (grade ≥ III) rates were 9.3{\%}, 1.7{\%}, and 1.9{\%}, respectively. The graft types and remaining liver volume were associated with significantly different overall, biliary, and major complication rates. Of the 16 patients with major complications, 9 (56.3{\%}) involved biliary complications (2 biliary strictures [12.5{\%}] and 7 bile leakages [43.8{\%}]). Among the 832 donors, the mean aspartate transaminase, alanine aminotransferase, and total bilirubin levels were 23.9 ± 8.1 IU/L, 20.9 ± 11.3 IU/L, and 0.8 ± 0.4 mg/dL, respectively, 6 months after liver donation. In conclusion, biliary complications were the most common types of major morbidity in living liver donors. Donor hepatectomy can be performed successfully with minimal and easily controlled complications. Our study shows that prospective, nationwide cohort data provide an important means of investigating the safety in living liver donation. Liver Transplantation 23 999–1006 2017 AASLD.",
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