Morbidity in live liver donors: Standards-based adverse event reporting further refined

Christopher R. Shackleton, John M. Vierling, Nicholas Nissen, Paul Martin, Fred Poordad, Tram Tran, Steven D. Colquhoun, Ronaldw Busuttil

Research output: Contribution to journalReview article

19 Scopus citations

Abstract

Hypothesis: The true extent of morbidity among live liver donors remains poorly understood. In this unique and often high-profile area of surgery, the development of standards for defining and reporting complications would foster a better understanding of the incidence and magnitude of such adverse events (AEs). Design: Retrospective review of AEs among live liver donors. Setting: University-affiliated teaching hospital. Patients and Methods: Of 202 individuals undergoing evaluation for live liver donation, 42 (20.8%) proceeded to surgery. Thirty-four underwent a right lobectomy without the middle hepatic vein; 3, a left lateral segmentectomy. Any event causing a deviation from a patient's ideal course was considered an AE and subsequently classified according to a derived framework. Morbidity was defined as 1 or more AEs. Main Outcome Measures: Incidence, timing, type, severity, and impact of AEs. Results: No deaths or significant hepatic dysfunction occurred. In 5 (12%) of the 42 donors, the hepatectomy was aborted for anatomic reasons before parenchymal transection. Eight (22%) of the remaining 37 experienced 11 AEs, of which 10 completely resolved, whereas 1 AE (3%) resulted in a permanent disability (brachial plexopathy). The overall incidence of AEs was 0.30 per case. Ten (91%) of the 11 AEs presented within the first postoperative month. Conclusions: Most live liver donations are uncomplicated or do not lead to permanent consequence. The adoption of a standards-based classification framework for AEs in live liver donors would allow for an inclusive, consistent, and universally applicable method to collect, analyze, and report donor morbidity.

Original languageEnglish (US)
Pages (from-to)888-895
Number of pages8
JournalArchives of Surgery
Volume140
Issue number9
DOIs
StatePublished - Sep 1 2005
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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    Shackleton, C. R., Vierling, J. M., Nissen, N., Martin, P., Poordad, F., Tran, T., Colquhoun, S. D., & Busuttil, R. (2005). Morbidity in live liver donors: Standards-based adverse event reporting further refined. Archives of Surgery, 140(9), 888-895. https://doi.org/10.1001/archsurg.140.9.888