Perioperative complications after live-donor hepatectomy

Area of Science:

• Hepatobiliary Surgery
• Transplant Surgery
• Medical Complications Research

Background:

• Donor hepatectomy complications are not well-characterized across all healthcare settings.
• Existing data may lack generalizability due to varying hospital practices.

Purpose of the Study:

• To analyze the incidence and types of complications following live liver donor hepatectomy.
• To identify risk factors associated with these complications.
• To quantify the impact of complications on length of stay and hospital charges.

Main Methods:

• Utilized Nationwide Inpatient Sample data from 2000-2008 for live liver donors.
• Classified complications using International Classification of Diseases, Ninth Revision (ICD-9) codes.
• Employed logistic regression for risk factor analysis and negative binomial regression for length of stay and cost impact.

Main Results:

• 23% of 555 analyzed donors (representing 2783 nationwide) experienced complications; 5% had major complications.
• Ileus (27%) and atelectasis (26%) were the most frequent complications.
• Complications significantly increased length of stay (IRR 1.36) and hospital charges (IRR 1.25).
• No patient or hospital factors were found to be associated with complication occurrence.

Conclusions:

• Approximately 25% of liver donors face immediate postoperative complications, predominantly minor.
• The findings support the safety and efficacy of current live liver donation and donor selection protocols.
• Further research may explore specific minor complication management to optimize donor recovery.