{"title":"分析 177 例活体肝移植肝切除术中供体的发病率:印度西部一个高容量中心的经验。","authors":"Shailesh Sable, Vibha Varma, Sorabh Kapoor, Samriddhi Poyekar, Barun Nath, Vinay Kumaran","doi":"10.1007/s12664-024-01552-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Living donor liver transplant (LDLT) is based on the principle of double equipoise. Organ shortage in Asian countries has led to development of high-volume LDLT programs with good outcomes. Safety of live liver donor is the Achilles heel of LDLT program and every effort should be made to achieve low morbidity and near zero mortality rates.</p><p><strong>Methods: </strong>We retrospectively analyzed our prospectively maintained donor morbidity data (outcomes) of 177 donors in a new transplant program setup in western India by an experienced surgeon. The primary end point was to analyze the morbidity rates and the factors associated with it.</p><p><strong>Results: </strong>None of the donors in our cohort of 177 donors developed grade IV or V complication (Clavien-Dindo classification). One-fourth (1/4th) of the donors developed complications ranging from grade I to grade III(b). The rate of complications according to modified Clavien-Dindo classification is as follows: (1) grade I in 5.6% (n = 10), (2) grade II in 14.6% (n = 26), (3) grade III(a) in 3.9% (n = 7), (4) grade III(b) in 2.2% (n = 4). Three donors (1.6%) developed post-hepatectomy intra-abdominal bleeding and required re-exploration (grade IIIb). All of them recovered well post-surgery and are doing well in follow-up. The mean follow-up of the entire cohort was 2871 ± 521 days (range 1926-3736 days).</p><p><strong>Conclusion: </strong>Donor safety (outcome) is determined by meticulous donor surgery and good-quality remnant.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Analysis of donor morbidity in 177 donor hepatectomies for living donor liver transplant: Experience from a high-volume centre in western India.\",\"authors\":\"Shailesh Sable, Vibha Varma, Sorabh Kapoor, Samriddhi Poyekar, Barun Nath, Vinay Kumaran\",\"doi\":\"10.1007/s12664-024-01552-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Living donor liver transplant (LDLT) is based on the principle of double equipoise. Organ shortage in Asian countries has led to development of high-volume LDLT programs with good outcomes. Safety of live liver donor is the Achilles heel of LDLT program and every effort should be made to achieve low morbidity and near zero mortality rates.</p><p><strong>Methods: </strong>We retrospectively analyzed our prospectively maintained donor morbidity data (outcomes) of 177 donors in a new transplant program setup in western India by an experienced surgeon. The primary end point was to analyze the morbidity rates and the factors associated with it.</p><p><strong>Results: </strong>None of the donors in our cohort of 177 donors developed grade IV or V complication (Clavien-Dindo classification). One-fourth (1/4th) of the donors developed complications ranging from grade I to grade III(b). The rate of complications according to modified Clavien-Dindo classification is as follows: (1) grade I in 5.6% (n = 10), (2) grade II in 14.6% (n = 26), (3) grade III(a) in 3.9% (n = 7), (4) grade III(b) in 2.2% (n = 4). Three donors (1.6%) developed post-hepatectomy intra-abdominal bleeding and required re-exploration (grade IIIb). All of them recovered well post-surgery and are doing well in follow-up. The mean follow-up of the entire cohort was 2871 ± 521 days (range 1926-3736 days).</p><p><strong>Conclusion: </strong>Donor safety (outcome) is determined by meticulous donor surgery and good-quality remnant.</p>\",\"PeriodicalId\":13404,\"journal\":{\"name\":\"Indian Journal of Gastroenterology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian Journal of Gastroenterology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s12664-024-01552-y\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/4/17 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Gastroenterology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12664-024-01552-y","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/4/17 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景:活体肝移植(LDLT)基于双等位原则。亚洲国家的器官短缺导致了大量 LDLT 项目的发展,并取得了良好的效果。活体肝脏捐献者的安全性是 LDLT 项目的致命弱点,因此应尽一切努力实现低发病率和接近零的死亡率:我们回顾性地分析了在印度西部由一位经验丰富的外科医生建立的新移植项目中前瞻性保存的 177 位供体的发病率数据(结果)。主要终点是分析发病率及其相关因素:结果:在我们的 177 位供体中,没有一位出现 IV 级或 V 级并发症(Clavien-Dindo 分类)。四分之一(1/4)的供体出现了从 I 级到 III(b)级的并发症。根据修改后的克拉维恩-丁多分类法,并发症发生率如下:(1)I级占5.6%(10人),(2)II级占14.6%(26人),(3)III(a)级占3.9%(7人),(4)III(b)级占2.2%(4人)。有 3 名供体(1.6%)在肝切除术后出现腹腔内出血,需要再次手术(IIIb 级)。他们术后均恢复良好,随访情况良好。整个组群的平均随访时间为 2871 ± 521 天(范围为 1926-3736 天):供体安全(结果)取决于精细的供体手术和优质的残留物。
Analysis of donor morbidity in 177 donor hepatectomies for living donor liver transplant: Experience from a high-volume centre in western India.
Background: Living donor liver transplant (LDLT) is based on the principle of double equipoise. Organ shortage in Asian countries has led to development of high-volume LDLT programs with good outcomes. Safety of live liver donor is the Achilles heel of LDLT program and every effort should be made to achieve low morbidity and near zero mortality rates.
Methods: We retrospectively analyzed our prospectively maintained donor morbidity data (outcomes) of 177 donors in a new transplant program setup in western India by an experienced surgeon. The primary end point was to analyze the morbidity rates and the factors associated with it.
Results: None of the donors in our cohort of 177 donors developed grade IV or V complication (Clavien-Dindo classification). One-fourth (1/4th) of the donors developed complications ranging from grade I to grade III(b). The rate of complications according to modified Clavien-Dindo classification is as follows: (1) grade I in 5.6% (n = 10), (2) grade II in 14.6% (n = 26), (3) grade III(a) in 3.9% (n = 7), (4) grade III(b) in 2.2% (n = 4). Three donors (1.6%) developed post-hepatectomy intra-abdominal bleeding and required re-exploration (grade IIIb). All of them recovered well post-surgery and are doing well in follow-up. The mean follow-up of the entire cohort was 2871 ± 521 days (range 1926-3736 days).
Conclusion: Donor safety (outcome) is determined by meticulous donor surgery and good-quality remnant.
期刊介绍:
The Indian Journal of Gastroenterology aims to help doctors everywhere practise better medicine and to influence the debate on gastroenterology. To achieve these aims, we publish original scientific studies, state-of -the-art special articles, reports and papers commenting on the clinical, scientific and public health factors affecting aspects of gastroenterology. We shall be delighted to receive articles for publication in all of these categories and letters commenting on the contents of the Journal or on issues of interest to our readers.