Lee Okjoo, Kim Jong Man, Kim Sang Jin, Rhu Jinsoo, Choi Gyu-Seong, Joh Jae-Won
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea.
World J Surg. 2022 Jun;46(6):1474-1484. doi: 10.1007/s00268-022-06518-9. Epub 2022 Mar 22.
Spousal donors have gradually been accepted as an alternative living liver donors to alleviate the organ shortage and prevent donations from children. No information is available regarding the effects of spousal donation on donor safety and recipient outcomes. Our purpose in this study was to determine how spousal liver grafts in living donor liver transplantation (LDLT) affect donor safety and recipient outcomes compared with those of LDLT from children.
We retrospectively analyzed 656 patients, including spouses and children, who underwent a right or extended right hepatectomy for living liver donation between January 2009 and December 2018.
Spouses represented 18.8% (n = 123) of living liver donors. Female donors comprised 78.9% (n = 97) of spousal donors, and the proportion of male donors in the children group was 72.6% (n = 387). The mean donor operation time of the spousal group was shorter than that of the children group (330 min vs. 358 min; P = 0.011), and the complication rate in the spousal group was lower than that in the children group (12.2% vs. 22.9%; P = 0.006). However, there were no differences in severe complication rates, hospitalization, or liver function tests between the 2 groups at 3 months after donor surgery. The overall survival of recipients in the spousal group was not reduced compared to that of recipients in the children group.
The present study suggests that, with careful selection, spousal donation is feasible and safe in LDLT.
配偶捐赠者已逐渐被接受为活体肝供体的一种替代选择,以缓解器官短缺并避免儿童捐赠。目前尚无关于配偶捐赠对供体安全性和受者结局影响的信息。我们本研究的目的是确定与儿童活体肝移植(LDLT)相比,活体肝移植中的配偶肝移植如何影响供体安全性和受者结局。
我们回顾性分析了2009年1月至2018年12月期间接受右半肝或扩大右半肝切除术进行活体肝捐赠的656例患者,包括配偶和儿童。
配偶占活体肝供体的18.8%(n = 123)。女性供体占配偶供体的78.9%(n = 97),儿童组男性供体的比例为72.6%(n = 387)。配偶组的平均供体手术时间短于儿童组(330分钟对358分钟;P = 0.011),配偶组的并发症发生率低于儿童组(12.2%对22.9%;P = 0.006)。然而,供体手术后3个月时,两组在严重并发症发生率、住院情况或肝功能检查方面没有差异。配偶组受者的总体生存率与儿童组受者相比没有降低。
本研究表明,经过仔细选择,配偶捐赠在LDLT中是可行且安全的。