Perioperative Events in Living and Deceased Donor Liver Transplant Recipients: A Case Control Study

Living donor liver transplantation (LD) has been implemented as an alternative to deceased donor transplantation (DD). We reviewed the perioperative course of recipients of LD and recipients of DD at our institution with specific aims to compare intraoperative events, early complication rates, resource utilization, and patient survival. Methods: Following Institutional Review Board (IRB) approval, the first forty LD cases were retrospectively matched by age, sex, and primary reason for transplant with controls that underwent DD between June 30, 2000 and January 25, 2005. Preoperative data, intraoperative variables, and immediate postoperative data were collected. Statistical analysis included signed rank test, McNemar's test, Wald statistics, and stratified Cox proportional hazards model. Results: Calculated Model for End Stage Liver Disease (MELD) scores were higher for DD (median 18 vs. 14 with p=0.04). Anesthesia time was longer in LD (median 7.1 vs. 6.5, p=0.02). Hospital length of stay (LOS) was higher in LD (median 12 vs. 8 days, P=0.002). Seven of the 40 (17%) LD were deceased at the time of data collection, as were four (10%) of the DD. Conclusions: Comparison of DD and LD at our institution revealed few significant differences in perioperative variables. LD may have more postoperative complications and longer hospital stays but similar patient survival.