Morbidity in live liver donors: standards-based adverse event reporting further refined

Arch Surg. 2005 Sep;140(9):888-95; discussion 895-6. doi: 10.1001/archsurg.140.9.888.


Hypothesis: The true extent of morbidity among live liver donors remains poorly understood. In this unique and often high-profile area of surgery, the development of standards for defining and reporting complications would foster a better understanding of the incidence and magnitude of such adverse events (AEs).

Design: Retrospective review of AEs among live liver donors.

Setting: University-affiliated teaching hospital.

Patients and methods: Of 202 individuals undergoing evaluation for live liver donation, 42 (20.8%) proceeded to surgery. Thirty-four underwent a right lobectomy without the middle hepatic vein; 3, a left lateral segmentectomy. Any event causing a deviation from a patient's ideal course was considered an AE and subsequently classified according to a derived framework. Morbidity was defined as 1 or more AEs.

Main outcome measures: Incidence, timing, type, severity, and impact of AEs.

Results: No deaths or significant hepatic dysfunction occurred. In 5 (12%) of the 42 donors, the hepatectomy was aborted for anatomic reasons before parenchymal transection. Eight (22%) of the remaining 37 experienced 11 AEs, of which 10 completely resolved, whereas 1 AE (3%) resulted in a permanent disability (brachial plexopathy). The overall incidence of AEs was 0.30 per case. Ten (91%) of the 11 AEs presented within the first postoperative month.

Conclusions: Most live liver donations are uncomplicated or do not lead to permanent consequence. The adoption of a standards-based classification framework for AEs in live liver donors would allow for an inclusive, consistent, and universally applicable method to collect, analyze, and report donor morbidity.

MeSH terms

  • Adult
  • Female
  • Hepatectomy*
  • Humans
  • Liver Transplantation
  • Living Donors*
  • Male
  • Middle Aged
  • Postoperative Complications*
  • Retrospective Studies
  • Risk Management / standards*