Artículo
Right hepatectomy for living donation: Role of remnant liver volume in predicting hepatic dysfunction and complications
Facciuto, Marcelo; Contreras Saldivar, Alan; Singh, Manoj K.; Rocca, Juan Pablo; Taouli, Bachir; Oyfe, Irina
; LaPointe Rudow, Dianne; Gondolesi, Gabriel Eduardo
; Schiano, Thomas; Kim Schluger, Leona; Schwartz, Myron E.; Miller, Charles M.; Florman, Sander
Fecha de publicación:
02/2013
Editorial:
Elsevier
Revista:
Surgery
ISSN:
0039-6060
Idioma:
Inglés
Tipo de recurso:
Artículo publicado
Clasificación temática:
Resumen
BACKGROUND: Extensive attention has been placed on remnant liver volume (RLV) above other factors to ensure donor safety. METHODS: We performed a retrospective review of 137 right hepatectomies in live donors between June 1999 and November 2010. RESULTS: Median right lobe volume was 1,029 cm(3), which correlated with its actual weight (r = 0.63, P < .01); median RLV was 548 cm(3). Of the donors, 32 (24%) developed postoperative hepatic dysfunction (bilirubin >3 mg/dL or prothrombin time >18 s on postoperative day 4). RLV did not predict postoperative hepatic dysfunction (P = .9), but it was associated with peak international normalized ratio (INR) (P = .04). Donor age and male gender were predictors of increased bilirubin at postoperative day 4 (age, P = .03; gender, P = .02). Of the donors, 45 (33%) experienced complications, and 24 donors had RLVs <30%; 42% experienced complications compared to 31% of donors whose RLVs were greater than 30% (P = .3). Cell-saver utilization and aspartate-aminotransferase (AST) levels (OR = 3) were associated with complications. Volumetric assessment can predict RLV accurately. CONCLUSION: Although no demonstrable association between RLV <30% and complications was found, an RLV of 30% should remain the threshold for donor safety. Age and gender should be balanced in donors with a near threshold RLV of 30%. Surgical complexity, suggested by the need for intraoperative autoinfusion of blood and postoperative levels of AST, remained the independent predictor of complications.
Palabras clave:
Liver Trnasplant
,
Right Love
,
Living Donor
,
Volume
Archivos asociados
Licencia
Identificadores
Colecciones
Articulos(SEDE CENTRAL)
Articulos de SEDE CENTRAL
Articulos de SEDE CENTRAL
Citación
Facciuto, Marcelo; Contreras Saldivar, Alan; Singh, Manoj K.; Rocca, Juan Pablo; Taouli, Bachir; et al.; Right hepatectomy for living donation: Role of remnant liver volume in predicting hepatic dysfunction and complications; Elsevier; Surgery; 153; 5; 2-2013; 619-626
Compartir
Altmétricas