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

J Gastrointest Surg. 2016 Apr;20(4):757-64. doi: 10.1007/s11605-016-3080-8. Epub 2016 Jan 20.

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.

Keywords: ISGLS; Liver transplantation; Living donors; PHLF.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Hepatectomy / adverse effects*
  • Hepatectomy / methods
  • Humans
  • Hyperbilirubinemia / blood
  • Incidence
  • International Normalized Ratio
  • Length of Stay
  • Liver Failure / blood
  • Liver Failure / epidemiology*
  • Liver Failure / etiology*
  • Liver Transplantation
  • Living Donors*
  • Male
  • Middle Aged
  • Operative Time
  • Risk Factors
  • Young Adult