摘要
Background:Although left-lobe donation is considered safer,right-sided donor hepatectomy predominatesin adult living donor liver transplantation(LDLT).We hypothesized that bilateral proficiency with donorhepatectomy reduces overall donor complications.Methods:A retrospective review of 834 adult LDLT donors(221 left lobes)from January 2004 toDecember 2014 was performed,dividing cases into two eras based on left-graft experience.Donorcomplications within 6 months were investigated,focusing on graft side and surgical era.Results:The overall complication rate was 17.6%,and was higher in right-lobe donors.In Era 2,duringwhich left-lobe donation rates were three times higher,total complications decreased(14.7%vs.20.9%,P=0.02).A significant reduction in postoperative ascites accounted for the lower overall complication rate.The proportion of major biliary complications(BCs)was halved from 62.5%to 25.0%.Right-lobe donorcomplications also decreased significantly(15.8%vs.22.9%,P=0.032),demonstrating that it was not onlyincreased left-lobe donations leading to lowered complication rates,but also greater experience with donorhepatectomy in general.Conclusions:Accumulating experience with bilateral donor hepatectomy leads to decreased donormorbidity and comparable outcomes for right and left lobes,further enhancing the goal of donor safety whilebalancing recipient needs.
