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Complications common for living liver donors

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Reuters Health

Tuesday, September 9, 2008

NEW YORK (Reuters Health) - Thirty-eight percent of liver donors will experience a complication with their surgical procedure, and although in most cases the severity is low grade, a significant proportion of patients will experience a severe or even life-threatening complication, new research shows.

Prior studies that have assessed the complications that living liver donors can develop have been confined to single medical centers, according to the report in the journal Gastroenterology. The present study addressed this limitation by using data on complications for donors enrolled in the nine-center "Adult-to-Adult Living Donor Liver Transplantation Cohort Study."

Although most liver transplants involve whole livers from recently deceased organ donors, the serious shortage of organs has lead physicians to explore the use of living liver donors. After a portion of this large organ is surgically removed, it usual regenerates in the donor within 4 or 6 weeks. Similarly, the new liver will eventually grow to full size.

A total of 405 donors were accepted for donation between 1998 and 2003, Dr. Rafik M. Ghobrial from the University of California, Los Angeles, and colleagues report. Of these, 393 underwent donation and 12 had an aborted procedure.

Sixty-two percent of the liver donors had no complications, 21 percent had one complication, and 17 percent had two or more, for a total of 220 complications, the researchers found.

The bulk of the complications were minor (48 percent, grade 1) or caused no lasting disability (47 percent, grade 2). However, 4 percent of the complications caused lasting disability (grade 3) and 0.8 percent were fatal (grade 4).

The most common complication, accounting for 12 percent of cases, was bacterial infection, followed by a bile leak (9 percent) and a hernia (6 percent). In two cases, a clot formed in the portal vein.

The hospital readmission rate was 13 percent, and 4 percent of donors required multiple readmissions.

The findings from this study "should be used for the education and informed consent process for potential donors," Ghobrial and colleagues state. "Informed consent" is the mandatory procedure that requires physicians to fully explain to patients all of the risks and benefits of a procedure or treatment and to inform them of any alternatives, if any.

SOURCE: Gastroenterology, August 2008.

Reuters Health

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