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Are living liver donors at risk from life-threatening 'near-miss' events?
Date:4/25/2013

ocedures. Potentially life-threatening "near-miss" events included severe intraoperative bleeding, reoperation for bleeding, biliary reconstruction and pulmonary embolism.

A total of 71 centers (48%) responded to the survey, representing 21 countries, and performing 11,553 LDLTs procedures. Analysis shows that donor morbidity was 24% including five donors who required liver transplantation. Donor mortality was 0.2% (23/11,553), with the majority of deaths occurring within 60 days post-transplant and 19 deaths were a direct result of transplant surgery. Researchers reported that "near-miss" event and aborted surgery incidence was 1.1% and 1.2%, respectively.

Dr. Pomfret concludes, "It appears that the 0.2% donor mortality rate was consistent and independent of the center's experience performing LDLTs. However, increased experiencecenters performing more than 50 total LDLTsis associated with lower rates of aborted procedures and "near-miss" events. These potentially life-threatening complications must be discussed as part of the informed consent with any potential liver donor."

In a related editorial, Dr. Daniela Ladner, Assistant Professor of Surgery at Northwestern University Feinberg School of Medicine in Chicago, IL agrees, "Living liver donation is arguably the most invasive operation we as surgeons perform in willing patients with no demonstrable medical benefit, allowing them to donate a portion of their liver to save the life of someone with end-stage liver disease. As Dr. Pomfret and colleagues suggest, transplant surgeons are obligated to fully disclose all potential risk to donors." Dr. Ladner also suggests that all complications as well as near-miss events that did not reach the patient should be captured and systematically examined to identify areas of improvement with LDLT procedures and reduce life-threatening events for living donors.


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Contact: Dawn Peters
sciencenewsroom@wiley.com
781-388-8408
Wiley
Source:Eurekalert

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