%0 Journal Article %J Gastroenterology %D 2008 %T Donor morbidity after living donation for liver transplantation %A Ghobrial,R. M. %A Freise,C. E. %A Trotter,J. F. %A Tong,L. %A Ojo,A. O. %A Fair,J. H. %A Fisher,R. A. %A Emond,J. C. %A Koffron,A. J. %A Pruett,T. L. %A Olthoff,K. M. %K *Liver Transplantation / statistics & numerical data %K *Living Donors / statistics & numerical data %K Adult %K Female %K Hepatectomy / *adverse effects / mortality %K Humans %K Informed Consent %K Intraoperative Complications / epidemiology %K Length of Stay %K Logistic Models %K Male %K Middle Aged %K Odds Ratio %K Patient Education as Topic %K Patient Readmission %K Postoperative Complications / epidemiology %K Retrospective Studies %K Risk Assessment %K Risk Factors %K Severity of Illness Index %K United States %X BACKGROUND & AIMS: Reports of complications among adult right hepatic lobe donors have been limited to single centers. The rate and severity of complications in living donors were investigated in the 9-center Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL). METHODS: A retrospective observational study design was used. Participants included all potential living donors evaluated between 1998 and 2003. Complication severity was graded using the Clavien scoring system. RESULTS: Of 405 donors accepted for donation, 393 underwent donation, and 12 procedures were aborted. There were 245 donors (62%) who did not experience complications; 82 (21%) had 1 complication, and 66 (17%) had 2 or more. Complications were scored as grade 1 (minor; n = 106, 27%), grade 2 (potentially life threatening; n = 103, 26%), grade 3 (life threatening; n = 8, 2%), and grade 4 (leading to death; n = 3, 0.8%). Common complications included biliary leaks beyond postoperative day 7 (n = 36, 9%), bacterial infections (n = 49, 12%), incisional hernia (n = 22, 6%), pleural effusion requiring intervention (n = 21, 5%), neuropraxia (n = 16, 4%), reexploration (n = 12, 3%), wound infections (n = 12, 3%), and intraabdominal abscess (n = 9, 2%). Two donors developed portal vein thrombosis, and 1 had inferior vena caval thrombosis. Fifty-one (13%) donors required hospital readmission, and 14 (4%) required 2 to 5 readmissions. CONCLUSIONS: Adult living liver donation was associated with significant donor complications. Although most complications were of low-grade severity, a significant proportion were severe or life threatening. Quantification of complication risk may improve the informed consent process, perioperative planning, and donor care. %B Gastroenterology %7 39597 %V 135 %P 468 - 76 %8 Aug %G eng %N 2 %M 18505689 %R S0016-5085(08)00670-7 [pii] 10.1053/j.gastro.2008.04.018