Meng Haipeng, Yang Jiayin, Yan Lunan
Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China (mainland).
Med Sci Monit. 2016 May 14;22:1623-9. doi: 10.12659/msm.898440.
BACKGROUND As an important means to tackle the worldwide shortage of liver grafts, adult-adult living donor liver transplantation (A-ALDLT) is the most massive operation a healthy person could undergo, so donor safety is of prime importance. However, most previous research focused on recipients, while complications in donors have not been fully described or investigated. MATERIAL AND METHODS To investigate donor safety in terms of postoperative complications, the clinical data of 356 A-ALDLT donors in our center from January 2002 to September 2015 were retrospectively analyzed. These patients were divided into a pre-2008 group (before January 2008) and a post-2008 group (after January 2008). Donor safety was evaluated with regard to the type, frequency, and severity of postoperative complications. RESULTS There were no donor deaths in our center during this period. The overall complication rate was 23.0% (82/356). The proportion of Clavien I, II, III, and IV complications was 51.2% (42/82), 25.6% (21/82), 22.0% (18/82), and 1.2% (1/82), respectively. In all the donors, the incidence of Clavien I, II, III, and IV complications was 11.8% (42/356), 5.9% (21/356), 5.1% (18/356), and 0.3% (1/356), respectively. The overall complication rate in the post-2008 group was significantly lower than that in the pre-2008 group (18.1% (41/227) vs. 32.6% (42/129), P<0.01). Biliary complications were the most common, with an incidence of 8.4% (30/356). CONCLUSIONS The risk to A-ALDLT donors is controllable and acceptable with improvement in preoperative assessment and liver surgery.
背景 作为应对全球肝移植供体短缺的一项重要手段，成人-成人活体肝移植（A-ALDLT）是健康人可能接受的规模最大的手术，因此供体安全至关重要。然而，此前大多数研究聚焦于受体，而供体的并发症尚未得到充分描述或研究。
材料与方法 为了从术后并发症方面调查供体安全性，对2002年1月至2015年9月期间在本中心接受A-ALDLT的356例供体的临床资料进行回顾性分析。这些患者被分为2008年前组（2008年1月之前）和2008年后组（2008年1月之后）。从术后并发症的类型、发生率和严重程度方面评估供体安全性。
结果 在此期间本中心无供体死亡。总体并发症发生率为23.0%（82/356）。Clavien I、II、III和IV级并发症的比例分别为51.2%（42/82）、25.6%（21/82）、22.0%（18/82）和1.2%（1/82）。在所有供体中，Clavien I、II、III和IV级并发症的发生率分别为11.8%（42/356）、5.9%（21/356）、5.1%（18/356）和0.3%（1/356）。2008年后组的总体并发症发生率显著低于2008年前组（18.1%（41/227）对32.6%（42/129），P<0.01）。胆系并发症最为常见，发生率为8.4%（30/356）。
结论 随着术前评估和肝脏手术的改进，A-ALDLT供体所面临的风险是可控且可接受的。
