Donor evaluation, donor risks, donor outcome, and donor quality of life in adult-to-adult living donor liver transplantation

Andreas Pascher, Igor M. Sauer, Marc Walter, Enrique Lopez-Haeninnen, Tom Theruvath, Antonino Spinelli, Ruth Neuhaus, Utz Settmacher, Andrea R. Mueller, Thomas Steinmueller, Peter Neuhaus

Research output: Contribution to journalArticle

126 Citations (Scopus)

Abstract

Right lobe living donor liver transplantation (LD-LTx) is currently performed at an increasing number of transplant centers. Donor selection, donor safety, donor recovery, and postdonation psychological impairment are essential criteria to determine whether and under which conditions LD-LTx is justifiable. Before commencing the LD-LTx program, approval was obtained from the local ethics committee. Potential donors underwent a comprehensive multistep evaluation protocol to exclude any conditions that could lead to an increased operative risk. Each donation was approved by the local Living Donation Commission. Follow-up investigations were performed after 6 and 12 months. Liver regeneration was assessed by computed tomography scan and magnetic resonance imaging scan derived volumetries. Quality of life (QOL) was investigated according to the Anamnestic Comparative Self-Assessment Scale (ACSA) before donation, and 6 and 12 months after donation. As of December 2001, 43 right lobe living donations have been performed at the Charité, Campus Virchow, Berlin. None of the donors died or has suffered life-threatening or persisting complications. All patients recovered completely. Complications occared in 8 donors (18%). The incidence of perioperative surgical complications was 9%, comprising temporary biliary leakages (n = 3; 6.8%) as well as postoperative bleeding (n = 1). Liver volume regeneration approximated 72% ± 15% of predonation volume by 6 months and 85% ± 18% (mean ± SD) by 12 months. There was no evidence of significant psychological impairment after donation. QOL increased after donation compared with the preoperative state (P <.05). In our experience, LD-LTx has proven to be a practicable and safe procedure. However, there is a considerable risk of postoperative complications. The donor selection process plays a pivotal role in preventing complications. The discussion of potential risks, especially potential life-threatening risks, must be an integral part of informed consent.

Original languageEnglish
Pages (from-to)829-837
Number of pages9
JournalLiver Transplantation
Volume8
Issue number9
DOIs
Publication statusPublished - Sep 2002

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Living Donors
Liver Transplantation
Quality of Life
Tissue Donors
Donor Selection
Liver Regeneration
Psychology
Ethics Committees
Berlin
Informed Consent
Tomography
Magnetic Resonance Imaging
Hemorrhage
Transplants
Safety
Incidence

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Donor evaluation, donor risks, donor outcome, and donor quality of life in adult-to-adult living donor liver transplantation. / Pascher, Andreas; Sauer, Igor M.; Walter, Marc; Lopez-Haeninnen, Enrique; Theruvath, Tom; Spinelli, Antonino; Neuhaus, Ruth; Settmacher, Utz; Mueller, Andrea R.; Steinmueller, Thomas; Neuhaus, Peter.

In: Liver Transplantation, Vol. 8, No. 9, 09.2002, p. 829-837.

Research output: Contribution to journalArticle

Pascher, A, Sauer, IM, Walter, M, Lopez-Haeninnen, E, Theruvath, T, Spinelli, A, Neuhaus, R, Settmacher, U, Mueller, AR, Steinmueller, T & Neuhaus, P 2002, 'Donor evaluation, donor risks, donor outcome, and donor quality of life in adult-to-adult living donor liver transplantation', Liver Transplantation, vol. 8, no. 9, pp. 829-837. https://doi.org/10.1053/jlts.2002.34896
Pascher, Andreas ; Sauer, Igor M. ; Walter, Marc ; Lopez-Haeninnen, Enrique ; Theruvath, Tom ; Spinelli, Antonino ; Neuhaus, Ruth ; Settmacher, Utz ; Mueller, Andrea R. ; Steinmueller, Thomas ; Neuhaus, Peter. / Donor evaluation, donor risks, donor outcome, and donor quality of life in adult-to-adult living donor liver transplantation. In: Liver Transplantation. 2002 ; Vol. 8, No. 9. pp. 829-837.
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