“No go” donor hepatectomy in living-donor liver transplantation
Selection of appropriate donors after rigorous evaluation is of paramount importance in living-donor liver transplantation. Despite this, donor surgery may not proceed due to unforeseen reasons. The aim of this paper is to study reasons for “no go” donor hepatectomy in living liver donors.
Patients and methods
Donor operations stopped after surgical start, directly due to donor safety-related reasons, qualified for inclusion as “no go” donor hepatectomy. Living-donor evaluation was performed as per standard protocol. Data for consecutive living liver donors operated between April 2012 and November 2016 were analyzed to evaluate reasons for “no go” donor hepatectomy in a liver transplantation unit at a tertiary care teaching hospital.
In 307 donors, the operation was aborted in 7 (2.3 %). One patient had unexpected biliary pathology with fibrosis found intraoperatively. Operations in five donors were abandoned in view of liver parenchymal abnormalities (fibrosis/steatohepatitis). One donor had hemodynamically significant bradycardia after handling the round ligament. All these donors recovered uneventfully and remained well on follow-up.
“No go” donor hepatectomy remains a real possibility despite rigorous assessment. Although thresholds for on-table rejection of the donor after complete evaluation vary, “no go” hepatectomy is a calculated risk-avoidance approach.
KeywordsDonor selection Living-donor liver transplantation Outcome Living-donor safety
Living-donor liver transplantation
Live liver donor
Body mass index
Liver function tests
Liver attenuation index
Magnetic resonance cholangiopancreatography
Middle hepatic vein
Deceased-donor liver transplantation
Authors did not receive any funding/grants for this work.
Study conception: Viniyendra Pamecha; manuscript drafting: Shyam Sunder Mahansaria, Kishore GS Bharathy; data collection: Piyush Kumar Sinha, Shridhar Vasantrao Sasturkar; critical revision of the manuscript for important intellectual content: Viniyendra Pamecha, Archana Rastogi, Kishore GS Bharathy.
Compliance with ethical standards
Conflict of interest
Viniyendra Pamecha, Kishore G. S. Bharathy, Shyam S. Mahansaria, Piyush K. Sinha, Archana Rastogi and Shridhar V. Sasturkar have no conflicts of interest to disclose.
All authors declare no potential conflicts of interest, financial or otherwise. The study is in accordance with the 1964 Helsinki Declaration and approved by the Institute’s review board and ethics committee. Standard protocol was followed in clinical management, and informed consent was obtained from all individual participants included in the study.
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