[Safety of donor of right lobe graft in living donor liver transplantation]

Abstract

Objective: To evaluate the safety of donors of right lobe graft.

Methods: We retrospectively studied 13 living donors of right lobe graft from January 2002 to June 2005. The right lobe grafts were obtained by transecting the liver on the right side of the middle hepatic vein. Liver transection was done by using an ultrasonic dissector without inflow vascular occlusion. The standard liver volume and the ratio of left lobe volume to the standard liver volume were calculated.

Results: The mean blood loss was 490 ml. The mean blood transfusion was 440 ml. In the perioperative period the mean albumin administered was 85 g. One donor had portal vein trifurcation, two had a right posterior bile duct and a right anterior bile duct draining into the left bile duct, respectively. One had bile ducts from left lateral and left internal segment and right duct draining into common hepatic duct. On postoperative day 1 the donors' liver functions were found impaired to some extent, but all the indices rapidly returned to the normal level at the end of the first week. Postoperative complications included 1 case of abdominal bleeding, 2 wound steatosis and 1 chyle leak. There was no donor mortality. All donors are well and have returned to their previous occupations.

Conclusions: The donation of right lobe graft for adult living donor liver transplantation is safe provided that the patency of the remnant hepatic vasculature and bile duct is ensured, the volume of the remnant liver exceeds 30% of the total liver volume, and there is no injury to the remnant liver.