Revisiting donor risk over two decades of single-center experience: More attention on the impact of overweight
Summary: Objective: Morbidity rates after living donor hepatectomy vary greatly among centers. Donor morbidity in a tertiary center over the past two decades was revisited. Methods: Clinical data and grading of complications were reviewed by a nontransplant surgeon based on Clavien 5 tier grading....
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2019-01-01
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| Series: | Asian Journal of Surgery |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1015958417306735 |
| _version_ | 1819241256931295232 |
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| author | Cheng-Maw Ho Yu-Min Huang Rey-Heng Hu Yao-Ming Wu Ming-Chih Ho Po-Huang Lee |
| author_facet | Cheng-Maw Ho Yu-Min Huang Rey-Heng Hu Yao-Ming Wu Ming-Chih Ho Po-Huang Lee |
| author_sort | Cheng-Maw Ho |
| collection | DOAJ |
| description | Summary: Objective: Morbidity rates after living donor hepatectomy vary greatly among centers. Donor morbidity in a tertiary center over the past two decades was revisited. Methods: Clinical data and grading of complications were reviewed by a nontransplant surgeon based on Clavien 5 tier grading. Risk factors were analyzed. Results: In total, 473 consecutive living liver donors from 1997 to 2016 were included for analysis; 305 were right liver donors and 168 left liver donors, and the corresponding morbidity rates were 27.2% and 9.5%. The majority (81/99, 81.2%) of complications were grade I and II. Donors with morbidity compared with those without were significantly younger, nonoverweight body figure (BMI < 25), more as the right liver donors, and longer length of hospital stay. Right liver donation had significantly higher morbidity rates than did left liver donation in earlier periods (before 2011), but not thereafter. Multivariate modeling revealed that right lobe donation and overweight (BMI ≥ 25 kg/m2) were significant factors associated with donor morbidity, with adjusted hazard ratios HR (95% confidence interval) of 3.401 (1.909–6.060) and 0.550 (0.304–0.996), respectively. Further, overweight was a paradoxical risk factor in right donor hepatectomy with HR 0.422 (0.209–0.851), but the effect was nonsignificant in left liver donors. Most complications in overweight donors were grade I and not specific to liver surgery. Conclusions: The overall complication rate was 20.9%. Overweight might be protective against morbidity in right hepatectomy and warrants further deliberation. Keywords: living liver donor, morbidity, liver transplantation, overweight |
| first_indexed | 2024-12-23T14:21:02Z |
| format | Article |
| id | doaj.art-336f224ef2c748b19d2ebb5c3006f98c |
| institution | Directory Open Access Journal |
| issn | 1015-9584 |
| language | English |
| last_indexed | 2024-12-23T14:21:02Z |
| publishDate | 2019-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Surgery |
| spelling | doaj.art-336f224ef2c748b19d2ebb5c3006f98c2022-12-21T17:43:48ZengElsevierAsian Journal of Surgery1015-95842019-01-01421172179Revisiting donor risk over two decades of single-center experience: More attention on the impact of overweightCheng-Maw Ho0Yu-Min Huang1Rey-Heng Hu2Yao-Ming Wu3Ming-Chih Ho4Po-Huang Lee5Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan; College of Medicine, National Taiwan University, Taipei, TaiwanDepartment of Surgery, National Taiwan University Hospital, Taipei, TaiwanDepartment of Surgery, National Taiwan University Hospital, Taipei, Taiwan; College of Medicine, National Taiwan University, Taipei, TaiwanDepartment of Surgery, National Taiwan University Hospital, Taipei, Taiwan; College of Medicine, National Taiwan University, Taipei, TaiwanDepartment of Surgery, National Taiwan University Hospital, Taipei, Taiwan; College of Medicine, National Taiwan University, Taipei, Taiwan; Corresponding author. Department of Surgery, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan. Fax: +886 23568810.Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan; College of Medicine, National Taiwan University, Taipei, TaiwanSummary: Objective: Morbidity rates after living donor hepatectomy vary greatly among centers. Donor morbidity in a tertiary center over the past two decades was revisited. Methods: Clinical data and grading of complications were reviewed by a nontransplant surgeon based on Clavien 5 tier grading. Risk factors were analyzed. Results: In total, 473 consecutive living liver donors from 1997 to 2016 were included for analysis; 305 were right liver donors and 168 left liver donors, and the corresponding morbidity rates were 27.2% and 9.5%. The majority (81/99, 81.2%) of complications were grade I and II. Donors with morbidity compared with those without were significantly younger, nonoverweight body figure (BMI < 25), more as the right liver donors, and longer length of hospital stay. Right liver donation had significantly higher morbidity rates than did left liver donation in earlier periods (before 2011), but not thereafter. Multivariate modeling revealed that right lobe donation and overweight (BMI ≥ 25 kg/m2) were significant factors associated with donor morbidity, with adjusted hazard ratios HR (95% confidence interval) of 3.401 (1.909–6.060) and 0.550 (0.304–0.996), respectively. Further, overweight was a paradoxical risk factor in right donor hepatectomy with HR 0.422 (0.209–0.851), but the effect was nonsignificant in left liver donors. Most complications in overweight donors were grade I and not specific to liver surgery. Conclusions: The overall complication rate was 20.9%. Overweight might be protective against morbidity in right hepatectomy and warrants further deliberation. Keywords: living liver donor, morbidity, liver transplantation, overweighthttp://www.sciencedirect.com/science/article/pii/S1015958417306735 |
| spellingShingle | Cheng-Maw Ho Yu-Min Huang Rey-Heng Hu Yao-Ming Wu Ming-Chih Ho Po-Huang Lee Revisiting donor risk over two decades of single-center experience: More attention on the impact of overweight Asian Journal of Surgery |
| title | Revisiting donor risk over two decades of single-center experience: More attention on the impact of overweight |
| title_full | Revisiting donor risk over two decades of single-center experience: More attention on the impact of overweight |
| title_fullStr | Revisiting donor risk over two decades of single-center experience: More attention on the impact of overweight |
| title_full_unstemmed | Revisiting donor risk over two decades of single-center experience: More attention on the impact of overweight |
| title_short | Revisiting donor risk over two decades of single-center experience: More attention on the impact of overweight |
| title_sort | revisiting donor risk over two decades of single center experience more attention on the impact of overweight |
| url | http://www.sciencedirect.com/science/article/pii/S1015958417306735 |
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