Donor hepatectomy for living-donor liver transplantation.

Between September 1993 and November 1996, donor hepatectomy was performed in 22 living donor liver transplantation at Queen Mary Hospital, Hong Kong. In these donor operations, 7 extended right lobe grafts, 6 extended left lobe grafts and 9 left lateral segment grafts were obtained. The technique of donor operations consisted of initial hilar dissection, mobilization of the liver lobe, transection of the liver using ultrasonic dissector (without inflow or outflow vascular occlusion) at a plane on the left side of the middle hepatic vein for an extended right lobe graft, on the right side of the middle hepatic vein for an extended left lobe graft or on the right side of falciform ligament for a left lateral segment graft. The median blood loss was 775 ml. Complications occurred in 2 donors: one had incisional hernia and the other had biliary stricture. Both were treated successfully by re-operation. Currently all donors are well with completely normal liver biochemistry.