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The Incidence of Posthepatectomy Liver Failure Defined by the International Study Group of Liver Surgery among Living Donors

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

Although several publications have reported donor morbidities, deterioration of liver function, which may cause posthepatectomy liver failure (PHLF), was not assessed specifically.

Methods

The incidence of PHLF proposed by the International Study Group of Liver Surgery (ISGLS-PHLF) was analyzed among 257 living donors. ISGLS-PHLF was defined by an increased international normalized ratio and hyperbilirubinemia on or after postoperative day 5.

Results

ISGLS-PHLF was identified in 21 donors (8 %), of which 18 (85.7 %) were grade A, 2 (9.5 %) were grade B, and 1 (4.8 %) was grade C. The average hospital stay without ISGLS-PHLF was 15 ± 1 days, which extended along with increasing grades (p = 0.03). In univariate analysis, right hepatectomy was significantly associated with the incidence of ISGLS-PHLF (p = 0.02), and right hepatectomy (p = 0.002) and operation time (p = 0.01) in multivariate analysis. Of 176 right lobe donors, 19 (10.8 %) developed ISGLS-PHLF, of which 16 (84.2 %) were grade A, 2 (10.5 %) were grade B, and 1 (5.3 %) was grade C. Operation time was significantly associated with the incidence of ISGLS-PHLF in univariate (p = 0.002) and multivariate (p = 0.003) analyses.

Conclusions

Right lobe donation surgery is associated with a higher incidence of ISGLS-PHLF.

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Abbreviations

LDLT:

Living donor liver transplantation

PHLF:

Posthepatectomy liver failure

ISGLS:

International Study Group of Liver Surgery

INR:

International normalized ratio

CT:

Computed tomography

POD:

Postoperative day

SLV:

Standard liver volume

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Authors and Affiliations

  1. Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe City, Hyogo, Japan

    Kaori Kuramitsu, Takumi Fukumoto, Kenji Fukushima & Yonson Ku

  2. Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

    Tsuyoshi Kobayashi, Sho Okimoto & Hideki Ohdan

  3. Department of Surgery, National Hospital Organization Kobe Medical Center, Kobe, Japan

    Takeshi Iwasaki

  4. Department of Surgery, Division of Gastroenterological Surgery, Hyogo Cancer Center, Hyogo, Japan

    Masahiro Tominaga

  5. Department of Diagnostic Pathology, Graduate School of Medicine, Kobe University, Kobe, Japan

    Yoh Zen

Authors
  1. Kaori Kuramitsu
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  2. Takumi Fukumoto
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  3. Tsuyoshi Kobayashi
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  4. Kenji Fukushima
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  5. Sho Okimoto
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  6. Takeshi Iwasaki
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  7. Masahiro Tominaga
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  9. Hideki Ohdan
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  10. Yonson Ku
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Correspondence to Kaori Kuramitsu.

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Kuramitsu, K., Fukumoto, T., Kobayashi, T. et al. The Incidence of Posthepatectomy Liver Failure Defined by the International Study Group of Liver Surgery among Living Donors. J Gastrointest Surg 20, 757–764 (2016). https://doi.org/10.1007/s11605-016-3080-8

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  • DOI: https://doi.org/10.1007/s11605-016-3080-8

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