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Updated: Aug 15, 2026
Porcine Liver Transplantation Without Veno-Venous Bypass As an Extended Criteria Donor Model
Published on: August 17, 2022
Morbidity in live liver donors: standards-based adverse event reporting further refined
Christopher R Shackleton1, John M Vierling, Nicholas Nissen
1Center for Liver Diseases and Transplantation, Cedars-Sinai Medical Center, and Department of Surgery, The David Geffen School of Medicine at UCLA, USA. shackletonc@thelivercenter.org
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.
