Esmat G, Yosry A, El-Serafi M, Omar A, Doss W, Hosny A, Ghali A, Sabry H, Attia H, Kamel S, Said M, Gabali H, Lee S K, Tanaka K
Tropical Medicine, Cairo University, Cairo, Egypt.
Transplant Proc. 2005 Sep;37(7):3147-50. doi: 10.1016/j.transproceed.2005.07.059.
Living donor liver transplantation (LDLT) is an alternative source of organs for patients with end-stage liver disease (ESLD) in absence of deceased donor LT. In LDLT the greatest concern is donor safety. Our objective was to evaluate the outcome of donors after right lobe liver donation in a single LT center in Egypt.
Fifty LDL resections were performed from 2001 to 2004. The mean donor age was 29.2 +/- 6.4 years. Residual liver volume was 41.1 +/- 4.5%. Mean operative time was 560 +/- 62.2 minutes; mean ICU stay, less than 24 hours; mean hospital stay, 15.4 +/- 7.7 days; and mean follow-up period, 6 months.
There was no mortality. The overall complication rate was 68% (34 donors). Major complications included intraoperative bleeding in one, biliary leak in two, and pneumonia in three donors. Minor complications included mild pleural effusion in 13 donors, transient ascites in 10, mild depression in 7, intra-abdominal collections in 3, and wound infections in 1 donor. Residual liver volume did not affect the complication rate. None required reoperation. Return to predonation activity occurred within 6 to 8 weeks. No liver impairment occurred during follow-up.
Right lobe adult LDLT is a safe procedure with regard to donor outcome. Major complications occurred in only 10% of our series.
对于终末期肝病（ESLD）患者，在缺乏脑死亡供体肝移植（LT）的情况下，活体供肝肝移植（LDLT）是一种可供选择的器官来源。在LDLT中，最大的关注点是供体安全。我们的目的是评估埃及一家单一肝移植中心右半肝供肝后供体的结局。
2001年至2004年共进行了50例活体供肝切除术。供体平均年龄为29.2±6.4岁。残余肝体积为41.1±4.5%。平均手术时间为560±62.2分钟；平均重症监护病房（ICU）停留时间少于24小时；平均住院时间为15.4±7.7天；平均随访期为6个月。
无死亡病例。总体并发症发生率为68%（34例供体）。主要并发症包括1例术中出血、2例胆漏和3例供体肺炎。次要并发症包括13例供体出现轻度胸腔积液、10例出现短暂性腹水、7例出现轻度抑郁、3例出现腹腔内积液和1例出现伤口感染。残余肝体积不影响并发症发生率。无一例需要再次手术。6至8周内恢复到捐献前的活动状态。随访期间无肝功能损害发生。
就供体结局而言，成人右半肝LDLT是一种安全的手术。我们的系列研究中主要并发症仅发生在10%的病例中。
