10 March 2020 : Original article
Clinical Outcome of Residual Liver Volume and Hepatic Steatosis After Right-Lobe Living-Donor Hepatectomy
Chia-En Hsieh12ABCDEF*, Kuo-Hua Lin3ABEF, Ya-Lan Hsu1ABEF, Chen-Te Chou45CDEF, Chia-Bang Chen4BDEF, Ping-Yi Lin6BCDE, Chia-Cheng Lin3DEF, Yu-Ju Hung3DEF, Li-Chueh Weng7ABCDEF, Yao-Li Chen3ABCDEFDOI: 10.12659/AOT.919502
Ann Transplant 2020; 25:e919502
Abstract
BACKGROUND: We examine how residual liver volume (RLV) and hepatic steatosis (HS) of living liver donors affect the regeneration process and clinical outcomes.
MATERIAL AND METHODS: We longitudinally studied 58 donors who underwent right-lobe hepatectomy during the period February 2014 to February 2015 at a single medical institution. The patients were classified based on RLV (30–35%, 35–40%, 40–50%) subgroups and HS (<10%, 10–30%, 30–50%) subgroups. Clinical parameters such as clinical outcome, liver volumetric recovery (LVR,%) rate and remnant left-liver (RLL,%) growth rate were collected for analysis.
RESULTS: The clinical features of postoperative peak total bilirubin (p=.024) were significant in the 3 RLV subgroups. Body mass index (p=.017), preoperative alanine transaminase (p<.001), and pleural effusion (p=.038) were significant in the 3 HS subgroups. The LVR rate and RLL growth rate equations showed significant variation in regeneration among the 3 RLV subgroups. The LVR rate and RLL growth rate equations did not show significant variation in regeneration among the 3 HS subgroups.
CONCLUSIONS: Hyperbilirubinemia was a risk factor in the small-RLV group, and a large amount of pleural effusion was a risk factor in the steatosis 30–50% group. Hepatic steatosis subgroups did not show significantly different degrees of regeneration. The safety of living donors was a major concern while we compiled the extended living-donor criteria presented in this paper.
Keywords: Donor Selection, Liver Regeneration, Living Donors, Fatty Liver, Hepatectomy, Liver, Organ Size, Postoperative Complications, Tissue and Organ Harvesting, young adult
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