DONOR SAFETY IN LIVING DONOR LIVER TRANSPLANTATION: EXPERIENCE OF TWO MEDICAL CENTRES FROM ROMANIA AND REPUBLIC OF MOLDOVA

Abstract

Introduction. Living donor liver transplantation (LDLT) has become a feasible treatment modality for end-stage liver disease. The objective of the study was to assess donor safety in LDLT. Material and methods. The present study assessed donor safety in LDTL in 157 living donation procedures performed in two transplant centres: Bucharest (Romania) and Chisinau (Republic of Moldova). We reviewed data of living liver donors who underwent procedures between 2000 and 2020. The outcomes were evaluated over two time periods (2000-2009 and 2010-2020) using the validated Clavien 5-tier grading system. Results. Different grafts were obtained from the 157 donor procedures (112 right lobe, 14 left lobe, and 31 left lateral segments). The mean age of living donors (LDs) was 33±8.62 years, proportion of men 47.1%. The mean duration of surgery was shorter in the latest period than in initial period (347.4 vs. 257.57 min, p<0.001, respectively). A longer postoperative hospital stay was observed in LDs from initial period of study than in the latest period (16.73 vs 13.61 days, p=0.026 respectively). One or more complications were experienced by 49.7% of donors and the rate of major complications was 5.1%. The two most common major complications were bile leakage (6.4%) and subphrenic access (5.7%). The rate of complications for LDs in the initial period of study was 1.33 and for the latest period 1.23. Conclusions. Donor hepatectomy can be performed successfully with minimal and easily controlled complications. Biliary complications were the most common type of major donor complication among living LDs.