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Brief Report | Resident's Forum

Perioperative Complications After Live-Donor Hepatectomy

Erin C. Hall, MD, MPH1,2; Brian J. Boyarsky, BA1; Neha A. Deshpande, BA1; Jacqueline M. Garonzik-Wang, MD, PhD1; Jonathan C. Berger, MD, MHS1; Nabil N. Dagher, MD1; Dorry L. Segev, MD, PhD1,3
[+] Author Affiliations
1Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
2Department of Surgery, Georgetown University School of Medicine, Washington DC
3Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
JAMA Surg. 2014;149(3):288-291. doi:10.1001/jamasurg.2013.3835.
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Current studies of complications following donor hepatectomy may not be generalizable to all hospitals performing this procedure. To address this, live liver donors were identified in the Nationwide Inpatient Sample (2000-2008). Complications after donor hepatectomy were categorized using International Classification of Diseases, Ninth Revision codes and risk factors for complications were tested using logistic regression. Negative binomial regression models were used to estimate the increase in length of stay and hospital charge associated with complications. Among 555 donors (representing 2783 donors nationwide), 23% had 1 or more complications and 5% had a major complication. The most common complications were ileus (27%) and atelectasis (26%). No patient or hospital factors were associated with complications. Having any complication was associated with increased length of stay (incidence rate ratio, 1.36; 95% CI, 1.16-1.58; P < .001) and hospital charge (incidence rate ratio, 1.25; 95% CI, 1.09-1.44; P = .002). Approximately 25% of liver donors have complications immediately postoperatively but most are minor, lending support to current practices in live liver donation and donor selection.

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