Is Systemic heparinization necessary during living donor hepatectomy?

Area of Science:

• Transplantation Surgery
• Hepatobiliary Surgery
• Surgical Outcomes Research

Background:

• Systemic heparinization is commonly used in living donor hepatectomy (LDH) to prevent graft vascular thrombosis.
• A consensus on its necessity during LDH is lacking.
• This study investigates the impact of systemic heparinization on donor and recipient outcomes.

Purpose of the Study:

• To compare donor and recipient outcomes with and without systemic heparinization during LDH.
• To determine the necessity of administering systemic heparin to living liver donors.

Main Methods:

• Retrospective review of 137 living donor hepatectomies (LDH) from January 2011 to October 2013.
• Comparison of outcomes between 79 donors receiving systemic heparin (group I) and 58 not receiving it but receiving heparinized perfusate flush (group II).
• Analysis of patient demographics, intraoperative parameters, laboratory data, postoperative complications, and survival rates.

Main Results:

• No significant difference in overall complication rates between groups.
• Higher incidence of postoperative bleeding requiring transfusion in the systemic heparin group (7.6% vs. 0.0%, P=0.03).
• Similar graft vascular thrombosis rates and no early graft loss; comparable posttransplant graft function and survival.

Conclusions:

• Omission of systemic heparinization during LDH is feasible and safe.
• No adverse effects on donor or recipient outcomes were observed.
• Alternative graft flushing with heparinized perfusate appears sufficient to prevent thrombosis.