Donor Complications in Adult Living Donor Liver Transplantation: Experience of Algiers Center

Purpose: Donor hepatectomy is a major operation with potential for major morbidity and mortality. The aim of this study is to evaluate donor complications in adult-to-adult living donor liver transplantation.
Patients and methods: Between February 2003 and June 2016, we performed 39 living donor liver resections. Right hepatectomy was performed in 37 cases, left hepatectomy in 1 case and in 1 case the procedure was discontinued after hepatic transection. Mediane donor age was 26 years (range, 18-58), 56% (22 donors) were females and the mean remnant liver volume to body weight ratio of 0,8 (range, 0,7-1,5). Complications were graded by Calvien’s classification. In this study, grade I and II were considered minor complications and grade III and IV major complications.
Results: There was no mortality. The overall complications rate was 51% (20 donors), with a total of 31 complications recognized. They were scored as grade I in 6 cases (19,5%), grade II in 15 cases (48,5%), grade IIIa in 3 cases (9,5%), grade IIIb in 6 cases (19,5%) and grade IVa in 1 case (3%). These complications were related with the hepatectomy in 22 cases (71%) and with general surgery in 9 (29%). They were minor in 21 cases (68%) and major in 10 cases (32%). These major complications were encountered in 8 donors (20,5%). All the donors are alive without any late complications.
Conclusions: In our experience, donor hepatectomy was associated with significant donor complications. However, most complications were low-grade severity. The donor safety is controllable and acceptable with improvement in liver surgery.