Li Fu-Gui, Yan Lu-Nan, Zeng Yong, Yang Jia-Yin, Lin Qi-Yuan, Jiang Xiao-Zhong, Liu Bin
The Center of Liver Transplantation, the Second Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
World J Gastroenterol. 2007 Jul 21;13(27):3752-5. doi: 10.3748/wjg.v13.i27.3752.
To evaluate the safety of donors in adult living donor liver transplantation (LDLT) using the right lobe in a single liver transplantation center in China.
We investigated retrospectively 52 living donor liver resections performed from October 2003 to July 2006. All patients were evaluated by blood tests and abdominal CT. The mean donor age was 28.2 +/- 7.4 years. Residual liver volume was 42.1% +/- 4.7%. Mean operative time was 420 +/- 76.2 min; mean ICU stay, less than 36 h; mean hospital stay, 16.4 +/- 8.6 d; and mean follow-up period, 6 mo.
There was no mortality. The overall complication rate was 40% (21 donors). Major complications included biliary leak in two, and pneumonia in 2 donors. Minor complications included mild pleural effusion in 12 donors, transient ascites in 6, mild depression in 4, intra-abdominal collections in 2, and wound infections in 1 donor. Residual liver volume did not affect the complication rate. None required re-operation. Return to pre-donation activity occurred within 5-8 wk.
Right hemi-hepatectomy can be performed safely with minimal risk in cases of careful donor selection. Major complications occurred in only 7.7% of our series.
在中国一家肝脏移植中心评估成人活体肝移植（LDLT）中供体使用右半肝的安全性。
我们回顾性研究了2003年10月至2006年7月期间进行的52例活体供肝切除术。所有患者均通过血液检查和腹部CT进行评估。供体平均年龄为28.2±7.4岁。残余肝体积为42.1%±4.7%。平均手术时间为420±76.2分钟；平均重症监护病房（ICU）停留时间少于36小时；平均住院时间为16.4±8.6天；平均随访期为6个月。
无死亡病例。总体并发症发生率为40%（21例供体）。主要并发症包括2例胆漏和2例肺炎。次要并发症包括12例轻度胸腔积液、6例短暂性腹水、4例轻度抑郁、2例腹腔积液和1例伤口感染。残余肝体积不影响并发症发生率。无一例需要再次手术。5至8周内恢复到捐赠前的活动水平。
在仔细选择供体的情况下，右半肝切除术可以安全地进行，风险极小。我们的系列研究中主要并发症仅发生在7.7%的病例中。
