Evolution of donor morbidity in living related liver transplantation: a single-center analysis of 165 cases.

Standard

Evolution of donor morbidity in living related liver transplantation: a single-center analysis of 165 cases. / Broering, Dieter C; Wilms, Christian; Bok, Pamela; Fischer, Lutz; Mueller, Lars; Hillert, Christian; Lenk, Christian; Kim, Jong-Sun; Sterneck, Martina; Schulz, Karl-Heinz; Krupski, Gerrit; Nierhaus, Axel; Ameis, Detlef; Burdelski, Martin; Rogiers, Xavier.

In: ANN SURG, Vol. 240, No. 6, 6, 2004, p. 1013-1016.

Research output: SCORING: Contribution to journalSCORING: Journal articleResearchpeer-review

Harvard

Broering, DC, Wilms, C, Bok, P, Fischer, L, Mueller, L, Hillert, C, Lenk, C, Kim, J-S, Sterneck, M, Schulz, K-H, Krupski, G, Nierhaus, A, Ameis, D, Burdelski, M & Rogiers, X 2004, 'Evolution of donor morbidity in living related liver transplantation: a single-center analysis of 165 cases.', ANN SURG, vol. 240, no. 6, 6, pp. 1013-1016. <http://www.ncbi.nlm.nih.gov/pubmed/15570207?dopt=Citation>

APA

Broering, D. C., Wilms, C., Bok, P., Fischer, L., Mueller, L., Hillert, C., Lenk, C., Kim, J-S., Sterneck, M., Schulz, K-H., Krupski, G., Nierhaus, A., Ameis, D., Burdelski, M., & Rogiers, X. (2004). Evolution of donor morbidity in living related liver transplantation: a single-center analysis of 165 cases. ANN SURG, 240(6), 1013-1016. [6]. http://www.ncbi.nlm.nih.gov/pubmed/15570207?dopt=Citation

Vancouver

Broering DC, Wilms C, Bok P, Fischer L, Mueller L, Hillert C et al. Evolution of donor morbidity in living related liver transplantation: a single-center analysis of 165 cases. ANN SURG. 2004;240(6):1013-1016. 6.

Bibtex

@article{a93d7f0b6a12496a8d88fab3a7bb5b0e,
title = "Evolution of donor morbidity in living related liver transplantation: a single-center analysis of 165 cases.",
abstract = "OBJECTIVE: During the last 14 years, living donor liver transplantation (LDLT) has evolved to an indispensable surgical strategy to minimize mortality of adult and pediatric patients awaiting transplantation. The crucial prerequisite to performing this procedure is a minimal morbidity and mortality risk to the healthy living donor. Little is known about the learning curve involved with this type of surgery. PATIENTS AND METHODS: From January 1991 to August 2003, a total of 165 LDLTs were performed in our center. Of these, 135 were donations of the left-lateral lobe (LL, segments II and III), 3 were of the left lobe (L, segments II-IV), 3 were full-left lobes (FL, segments I-IV), and 24 were of the full-right lobe (FR, segments V-VIII). We divided the procedures into 3 periods: period 1 included the years 1991 to 1995 (LL, n = 49; L, n = 2; FR, n = 1), period 2 covered 1996 to 2000 (LL, n = 47), and period 3 covered 2001 to August 2003 (LL, n = 39; FR, n = 23; FL, n = 3; L, n = 1). Perioperative mortality and morbidity were assessed using a standardized classification. Length of stay in intensive care unit, postoperative hospital stay, laboratory results (bilirubin, INR, and LFTs), morbidity, and the different types of grafts in the 3 different periods were compared. RESULTS: One early donor death was observed in period 1 (03/07/93, case 30; total mortality, 0.61.%). Since 1991, the perioperative morbidity has continually declined (53.8% vs. 23.4% vs. 9.2%). In period 1, 28 patients had 40 complications. In period 2, 11 patients had 12 complications, and in period 3, 6 patients had 9 complications. Within the first period, 1 donor underwent relaparotomy because of bile leakage. Postoperative hospital stay was 10 days, 7 days, and 6 days, respectively. Donation of the full right lobe, in comparison with that of the left lateral lobe, resulted in a significantly diminished liver function (bilirubin and INR) during the first 5 days after donation but did not increase morbidity. One donor from period 1 experienced late death caused by amyotrophic lateral sclerosis. CONCLUSIONS: In a single center, morbidity after living liver donation strongly correlates to center experience. Despite the additional risks associated with temporary reduction of liver function, this experience enabled the team to bypass part of the learning curve when starting right lobe donation. Specific training of the surgical team and coaching by an experienced center should be implemented for centers offering this procedure to avoid the learning curve.",
author = "Broering, {Dieter C} and Christian Wilms and Pamela Bok and Lutz Fischer and Lars Mueller and Christian Hillert and Christian Lenk and Jong-Sun Kim and Martina Sterneck and Karl-Heinz Schulz and Gerrit Krupski and Axel Nierhaus and Detlef Ameis and Martin Burdelski and Xavier Rogiers",
year = "2004",
language = "Deutsch",
volume = "240",
pages = "1013--1016",
journal = "ANN SURG",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

RIS

TY - JOUR

T1 - Evolution of donor morbidity in living related liver transplantation: a single-center analysis of 165 cases.

AU - Broering, Dieter C

AU - Wilms, Christian

AU - Bok, Pamela

AU - Fischer, Lutz

AU - Mueller, Lars

AU - Hillert, Christian

AU - Lenk, Christian

AU - Kim, Jong-Sun

AU - Sterneck, Martina

AU - Schulz, Karl-Heinz

AU - Krupski, Gerrit

AU - Nierhaus, Axel

AU - Ameis, Detlef

AU - Burdelski, Martin

AU - Rogiers, Xavier

PY - 2004

Y1 - 2004

N2 - OBJECTIVE: During the last 14 years, living donor liver transplantation (LDLT) has evolved to an indispensable surgical strategy to minimize mortality of adult and pediatric patients awaiting transplantation. The crucial prerequisite to performing this procedure is a minimal morbidity and mortality risk to the healthy living donor. Little is known about the learning curve involved with this type of surgery. PATIENTS AND METHODS: From January 1991 to August 2003, a total of 165 LDLTs were performed in our center. Of these, 135 were donations of the left-lateral lobe (LL, segments II and III), 3 were of the left lobe (L, segments II-IV), 3 were full-left lobes (FL, segments I-IV), and 24 were of the full-right lobe (FR, segments V-VIII). We divided the procedures into 3 periods: period 1 included the years 1991 to 1995 (LL, n = 49; L, n = 2; FR, n = 1), period 2 covered 1996 to 2000 (LL, n = 47), and period 3 covered 2001 to August 2003 (LL, n = 39; FR, n = 23; FL, n = 3; L, n = 1). Perioperative mortality and morbidity were assessed using a standardized classification. Length of stay in intensive care unit, postoperative hospital stay, laboratory results (bilirubin, INR, and LFTs), morbidity, and the different types of grafts in the 3 different periods were compared. RESULTS: One early donor death was observed in period 1 (03/07/93, case 30; total mortality, 0.61.%). Since 1991, the perioperative morbidity has continually declined (53.8% vs. 23.4% vs. 9.2%). In period 1, 28 patients had 40 complications. In period 2, 11 patients had 12 complications, and in period 3, 6 patients had 9 complications. Within the first period, 1 donor underwent relaparotomy because of bile leakage. Postoperative hospital stay was 10 days, 7 days, and 6 days, respectively. Donation of the full right lobe, in comparison with that of the left lateral lobe, resulted in a significantly diminished liver function (bilirubin and INR) during the first 5 days after donation but did not increase morbidity. One donor from period 1 experienced late death caused by amyotrophic lateral sclerosis. CONCLUSIONS: In a single center, morbidity after living liver donation strongly correlates to center experience. Despite the additional risks associated with temporary reduction of liver function, this experience enabled the team to bypass part of the learning curve when starting right lobe donation. Specific training of the surgical team and coaching by an experienced center should be implemented for centers offering this procedure to avoid the learning curve.

AB - OBJECTIVE: During the last 14 years, living donor liver transplantation (LDLT) has evolved to an indispensable surgical strategy to minimize mortality of adult and pediatric patients awaiting transplantation. The crucial prerequisite to performing this procedure is a minimal morbidity and mortality risk to the healthy living donor. Little is known about the learning curve involved with this type of surgery. PATIENTS AND METHODS: From January 1991 to August 2003, a total of 165 LDLTs were performed in our center. Of these, 135 were donations of the left-lateral lobe (LL, segments II and III), 3 were of the left lobe (L, segments II-IV), 3 were full-left lobes (FL, segments I-IV), and 24 were of the full-right lobe (FR, segments V-VIII). We divided the procedures into 3 periods: period 1 included the years 1991 to 1995 (LL, n = 49; L, n = 2; FR, n = 1), period 2 covered 1996 to 2000 (LL, n = 47), and period 3 covered 2001 to August 2003 (LL, n = 39; FR, n = 23; FL, n = 3; L, n = 1). Perioperative mortality and morbidity were assessed using a standardized classification. Length of stay in intensive care unit, postoperative hospital stay, laboratory results (bilirubin, INR, and LFTs), morbidity, and the different types of grafts in the 3 different periods were compared. RESULTS: One early donor death was observed in period 1 (03/07/93, case 30; total mortality, 0.61.%). Since 1991, the perioperative morbidity has continually declined (53.8% vs. 23.4% vs. 9.2%). In period 1, 28 patients had 40 complications. In period 2, 11 patients had 12 complications, and in period 3, 6 patients had 9 complications. Within the first period, 1 donor underwent relaparotomy because of bile leakage. Postoperative hospital stay was 10 days, 7 days, and 6 days, respectively. Donation of the full right lobe, in comparison with that of the left lateral lobe, resulted in a significantly diminished liver function (bilirubin and INR) during the first 5 days after donation but did not increase morbidity. One donor from period 1 experienced late death caused by amyotrophic lateral sclerosis. CONCLUSIONS: In a single center, morbidity after living liver donation strongly correlates to center experience. Despite the additional risks associated with temporary reduction of liver function, this experience enabled the team to bypass part of the learning curve when starting right lobe donation. Specific training of the surgical team and coaching by an experienced center should be implemented for centers offering this procedure to avoid the learning curve.

M3 - SCORING: Zeitschriftenaufsatz

VL - 240

SP - 1013

EP - 1016

JO - ANN SURG

JF - ANN SURG

SN - 0003-4932

IS - 6

M1 - 6

ER -