Donor safety in living donor liver donation: An Italian multicenter survey

Andrea Lauterio, S. Di Sandro, S. Gruttadauria, Marco Spada, Fabrizio Di Benedetto, Umberto Baccarani, Enrico Regalia, Ernesto Melada, Alessandro Giacomoni, M. Cescon, Davide Cintorino, G. Ercolani, Matteo Rota, Giorgio Ettore Rossi, Vincenzo Mazzaferro, Andrea Risaliti, A. D. Pinna, Bruno Gridelli, L. de Carlis

Research output: Contribution to journalArticlepeer-review


Major concerns about donor morbidity and mortality still limit the use of living donor liver transplantation (LDLT) to overcome the organ shortage. The present study assessed donor safety in LDLT in Italy reporting donor postoperative outcomes in 246 living donation procedures performed by 7 transplant centers. Outcomes were evaluated over 2 time periods using the validated Clavien 5-tier grading system, and several clinical variables were analyzed to determine the risk factors for donor morbidity. Different grafts were obtained from the 246 donor procedures (220 right lobe, 10 left lobe, and 16 left lateral segments). The median follow-up after donation was 112 months. There was no donor mortality. One or more complications occurred in 82 (33.3%) donors, and 3 of them had intraoperative complications (1.2%). Regardless of graft type, the rate of major complications (grade≥3) was 12.6% (31/246). The overall donor morbidity and the rate of major complications did not differ significantly over time: 26 (10.6%) donors required hospital readmission throughout the follow-up period, whereas 5 (2.0%) donors required reoperation. Prolonged operative time (>400 minutes), intraoperative hypotension (systolic<100mm Hg), vascular abnormalities, and intraoperative blood loss (>300mL) were multivariate risk factors for postoperative donor complications. In conclusion, from the standpoint of living donor surgery, a meticulous and well-standardized technique that reduces operative time and prevents blood loss and intraoperative hypotension may reduce the incidence of donor complications. Transparency in reporting results after LDLT is mandatory, and we should continue to strive for zero donor mortality. Liver Transplantation 2016 AASLD.

Original languageEnglish
Pages (from-to)184-193
JournalLiver Transplantation
Issue number2
Publication statusPublished - 2017

ASJC Scopus subject areas

  • Surgery
  • Hepatology
  • Transplantation


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