Comparison of right lobe donor hepatectomy with elective right hepatectomy for other causes in New York.

Abstract

INTRODUCTION:

Right lobe donor hepatectomy (RLDH) is a potential source of liver allografts given the ongoing shortage of deceased donor organs available. Since there is no live donor registry in the United States, a population-based, unsolicited state-wide analysis has yet to be reported.

METHODS:

The New York (NY) State Inpatient Database was used to query 1,524 elective liver lobectomies performed from 2001 to 2006. RLDH were identified in this cohort (n = 195; 13%). Most common indications for elective right lobe hepatectomy (ERH) were metastatic colon cancer (50%) and hepatocellular carcinoma (HCC) (34%). Primary outcomes were mortality, perioperative resources and major postoperative complications.

RESULTS:

After a dramatic drop in 2002, there was a slow increase in RLDH from 2003 to 2006 in New York. Donors were younger (median age 36 vs. 60 years, P < 0.0001) and healthier (75% with no comorbidities vs. 18%, P < 0.0001) than patients undergoing ERH for other causes. Median length of hospital stay was 7 days in both groups. Donors were less likely to require blood transfusion (22.6 vs. 62.8%, P < 0.0001) and received less blood (mean 0.10 units vs. 2.4 units). Major post-operative complications based on the Clavien classification occurred in only 2.6% of donor cases compared to 13.8% in non-donors (P < 0.0001). There was one RLDH in-hospital mortality (0.5%) in New York compared to 4.3% after ERH (P = 0.003).

CONCLUSIONS:

This study represents one of the first unsolicited regional analyses of donor morbidity and resource utilization for RLDH and further emphasizes the need and utility of a live donor registry.

• Authors: Andrew T Burr, Nicholas G Csikesz, Earl Gonzales, Jennifer F Tseng, Reza F Saidi, Adel Bozorgzadeh, Shimul A Shah
• Journal: Digestive diseases and sciences (Dig Dis Sci) Vol. 56 Issue 6 Pg. 1869-75 (Jun 2011) ISSN: 1573-2568 [Electronic] United States
• PMID: 21113662 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Aged
• Blood Transfusion
• Child
• Child, Preschool
• Cohort Studies
• Hepatectomy (adverse effects)
• Humans
• Infant
• Liver Transplantation
• Living Donors
• Middle Aged
• New York
• Postoperative Complications
• Retrospective Studies
• Young Adult