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PubMed ID:
18976306
Public Release Type:
Journal
Publication Year: 2008
Affiliation: Department of Surgery, University of California San Francisco, San Francisco, CA, USA. freisec@surgery.ucsf.edu
DOI:
https://doi.org/10.1111/j.1600-6143.2008.02440.x
Authors:
Lok AS,
Gillespie BW,
Freise CE,
Ghobrial RM,
Everhart JE,
A2ALL Study Group,
Trotter JF,
Olthoff KM,
Fisher RA,
Fair JH,
Emond JC,
Pruett TL,
Koffron AJ
Studies:
Adult Living Donor Liver Transplantation Studies
Patients considering living donor liver transplantation (LDLT) need to know the risk and severity of complications compared to deceased donor liver transplantation (DDLT). One aim of the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL) was to examine recipient complications following these procedures. Medical records of DDLT or LDLT recipients who had a living donor evaluated at the nine A2ALL centers between 1998 and 2003 were reviewed. Among 384 LDLT and 216 DDLT, at least one complication occurred after 82.8% of LDLT and 78.2% of DDLT (p = 0.17). There was a median of two complications after DDLT and three after LDLT. Complications that occurred at a higher rate (p < 0.05) after LDLT included biliary leak (31.8% vs. 10.2%), unplanned reexploration (26.2% vs. 17.1%), hepatic artery thrombosis (6.5% vs. 2.3%) and portal vein thrombosis (2.9% vs. 0.0%). There were more complications leading to retransplantation or death (Clavien grade 4) after LDLT versus DDLT (15.9% vs. 9.3%, p = 0.023). Many complications occurred more commonly during early center experience; the odds of grade 4 complications were more than two-fold higher when centers had performed <or=20 LDLT (vs. >40). In summary, complication rates were higher after LDLT versus DDLT, but declined with center experience to levels comparable to DDLT.
