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Morbidity and Mortality of Hepatic Right Lobe Living Donors: Systematic Review and Perspectives

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Pauline Brige1, Géraldine Hery1,2, Sophie Chopinet1,3, Anaïs Palen1,3, Daniel Azoulay4,5, Emilie Gregoire1, 3

1) Aix-Marseille University, Experimental Interventional Imaging Laboratory, European Center for Medical Imaging
Research, Marseille;
2) Aix-Marseille University, Department of Pediatric Surgery and Liver Transplantation, Hôpital de la Timone Enfant, Marseille;
3) Aix-Marseille University, Department of General Surgery and Liver Transplantation, Hôpital de la Timone, Marseille;
4) Department of HPB Surgery and Liver Transplantation, Hôpital Henri-Mondor, Créteil;
5) University Paris Est Créteil, Mondor Institute of Biomedical Research, INSERM U955, France

DOI: http://dx.doi.org/10.15403/jgld.2014.1121.272.mor

Background & Aims: The main restriction in the development of adult-adult Living Donor Liver Transplantation (LDLT) is the risk of morbidity and mortality for donors, which raises ethical questions. The objectives of this study are to review published studies dealing with morbidity and mortality in LDLT and to identify the proposed management and strategies for preventing donor mortality and morbidity in LDLT.
Methods: The Medline database was searched from 2000 to 2017 using the MeSH terms “liver transplantation” and “morbidity” or “mortality” in combination with keywords “living donor liver transplantation”.
Results: Among the 382 articles obtained, 43 articles were relevant for morbidity, 15 for mortality and 6 for both morbidity and mortality. Twenty-three papers reported donor deaths. The major cause of death was sepsis (30%). Morbidity ranged from 10% to 78.3% depending on the studies.
Conclusions: The living donors’ morbidity and mortality is high, currently representing the main restriction in the development of LDLT. Some promising techniques, such as the donor portal vein flow modulation could lead to the further development of LDLT.
Key words: living donor – living donor liver transplantation – morbidity – mortality – preconditioning.
Abbreviations: LDLT: Living Donor Liver Transplantation; LL: Left Lobe; MELD: Model for End-Stage Liver Disease; RL: Right Lobe; SFSS: Small For Size Syndrome.