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Comparison of Right Lobe Donor Hepatectomy with Elective Right Hepatectomy for Other Causes in New York
- Source :
- Digestive Diseases and Sciences. 56:1869-1875
- Publication Year :
- 2010
- Publisher :
- Springer Science and Business Media LLC, 2010.
-
Abstract
- Right lobe donor hepatectomy (RLDH) is a potential source of liver allografts given the ongoing shortage of deceased donor organs available. Since there is no live donor registry in the United States, a population-based, unsolicited state-wide analysis has yet to be reported.The New York (NY) State Inpatient Database was used to query 1,524 elective liver lobectomies performed from 2001 to 2006. RLDH were identified in this cohort (n = 195; 13%). Most common indications for elective right lobe hepatectomy (ERH) were metastatic colon cancer (50%) and hepatocellular carcinoma (HCC) (34%). Primary outcomes were mortality, perioperative resources and major postoperative complications.After a dramatic drop in 2002, there was a slow increase in RLDH from 2003 to 2006 in New York. Donors were younger (median age 36 vs. 60 years, P0.0001) and healthier (75% with no comorbidities vs. 18%, P0.0001) than patients undergoing ERH for other causes. Median length of hospital stay was 7 days in both groups. Donors were less likely to require blood transfusion (22.6 vs. 62.8%, P0.0001) and received less blood (mean 0.10 units vs. 2.4 units). Major post-operative complications based on the Clavien classification occurred in only 2.6% of donor cases compared to 13.8% in non-donors (P0.0001). There was one RLDH in-hospital mortality (0.5%) in New York compared to 4.3% after ERH (P = 0.003).This study represents one of the first unsolicited regional analyses of donor morbidity and resource utilization for RLDH and further emphasizes the need and utility of a live donor registry.
- Subjects :
- Adult
medicine.medical_specialty
Adolescent
Physiology
Live donor
medicine.medical_treatment
New York
Economic shortage
Liver transplantation
Cohort Studies
Young Adult
Postoperative Complications
Living Donors
medicine
Hepatectomy
Humans
Blood Transfusion
Potential source
Child
Aged
Retrospective Studies
Donor hepatectomy
Deceased donor
business.industry
General surgery
Gastroenterology
Infant
Middle Aged
Lobe
Liver Transplantation
Surgery
medicine.anatomical_structure
Child, Preschool
business
Subjects
Details
- ISSN :
- 15732568 and 01632116
- Volume :
- 56
- Database :
- OpenAIRE
- Journal :
- Digestive Diseases and Sciences
- Accession number :
- edsair.doi.dedup.....a360055b46338e3b8d3c4d7a988dbbbd