Liver Transplant Institute, Inonu University Faculty of Medicine, Turkey.
S Afr J Surg. 2020 Jun;58(2):91-100.
Aborted donor hepatectomy (ADH) during any stage of living donor hepatectomy (LDH) is a rare event. We describe our experience and discuss the lessons from these events.
From September 2005 to January 2019, 77 of 2 031 (3.79%) LDH were aborted at various stages of surgical procedure due to donor or recipient related reasons. Demographic and clinical data of aborted donor candidates and the clinical course of their potential recipients were analysed.
LDH of 77 donor candidates was aborted due to donor ( = 53) or recipient ( = 24) related reasons. The most common donor related reason was the quality of liver parenchyma ( = 31). The most common recipient related reason was haemodynamic instability ( = 11). Twenty-three recipients underwent either living donor liver transplantation (LDLT) ( = 21) or deceased donor liver transplantation (DDLT) ( = 2) at a median of 6 days following ADH. In one aborted due to a donor reason and two aborted for recipient reasons, LDLT was performed using the same donor candidates. Thirty-six recipients had no liver transplantation (LT) and died a median of 17.5 days following ADH.
We believe that ADH will decrease with experience and meticulous preoperative clinical and radiological evaluations. Abandoning the donor hepatectomy is always a valid option at any stage of the surgery when the unexpected is encountered.
在活体肝移植（LDH）的任何阶段进行的供体肝切除中止（ADH）是一种罕见的事件。我们描述了我们的经验，并讨论了从这些事件中吸取的教训。
从 2005 年 9 月至 2019 年 1 月，由于供体或受体相关原因，在手术的各个阶段，2031 例 LDH 中有 77 例（3.79%）被中止。分析了中止供体候选者的人口统计学和临床数据以及其潜在受者的临床过程。
77 名供体候选者的 LDH 因供体（=53）或受体（=24）相关原因而中止。最常见的供体相关原因是肝实质质量（=31）。最常见的受体相关原因是血流动力学不稳定（=11）。23 名受者在 ADH 后中位数为 6 天接受了活体供肝移植（LDLT）（=21）或尸体供肝移植（DDLT）（=2）。在因供体原因中止的一例和因受体原因中止的两例中，使用相同的供体候选者进行了 LDLT。36 名受者未接受肝移植（LT），并在 ADH 后中位数为 17.5 天死亡。
我们认为，随着经验的积累和术前细致的临床和影像学评估，ADH 的发生率将会降低。当遇到意外情况时，在手术的任何阶段放弃供体肝切除术始终是一个有效的选择。
