Liver regeneration and surgical outcome in donors of right-lobe liver grafts

Abstract

Introduction: Previous studies of healthy live-liver donors have suggested that complete liver regeneration occurs within a matter of weeks; however, there have been no long-term studies evaluating liver regeneration and few studies documenting long-term donor outcome.

Materials and methods: Fifty-one donors who provided right-lobe grafts underwent volumetric spiral computed tomography scans preoperatively and postoperatively at time intervals of 1 week and 1, 3, 6, and 12 months. Patient demographics, surgical data, and postoperative outcome were correlated with liver regeneration data. Donor surgical outcome was followed prospectively and recorded in a comprehensive database.

Results: Thirty-three males and 18 females (mean age 36.0+/-9.6 years) provided 51 right-lobe grafts. Mean follow-up was 9.8+/-3.4 months. No donor operation was aborted, and surgical morbidity and mortality rates were 39% and 0%, respectively. Donor remnant liver volume was 49.4+/-5.7% of the original total liver volume (TLV). Overall liver regeneration was 83.3+/-9.0% of the TLV by 1 year. Female donors had significantly slower liver regrowth when compared with males at 12 months (79.8+/-9.3% vs. 85.6+/-8.2%, P<0.01). There was no effect of age, body mass index, operative time, estimated blood loss, postoperative complications, or perioperative liver function tests on liver regeneration.

Discussion: Liver regeneration continues throughout the first postoperative year. Only one donor achieved complete liver regeneration during this time period; however, all donors have maintained normal liver function without long-term complications. Longer follow-up is needed to determine whether donors ever achieve original TLV.