The Analysis of Posthepatectomy Liver Failure Incidence and Risk Factors Among Right Liver Living Donors According to International Study Group of Liver Surgery Defination

Abstract Aim There is well-known risk of emergence of hepatic failure in living donor transplant cases who are performed right donor hepatectomy (RDH). There are different prevalence ratios in literature on this phenomenon. In our study, we aim to depict the prevalence of hepatic failure and risk factors in our cases regarding the most recent description criteria relating hepatic failure. Patients and methods We included right liver donor hepatectomy cases, who are fit to donor evaluation algorithm in Dokuz Eylul University Liver Transplantation Unit between the period of June 2000 and September 2017. The patients are evaluated regarding peroperative data retrospectively. Liver failure was defined according to International Study Group of Liver Surgery (ISGLS) criteria. We also included statistical analysis of risk factors that are potentially related with liver failure. Results We included a total of 276 patients. In 27(9.7%) patients we observed posthepatectomy liver failure (PHLF). In 26(9.4%) patients we observed Grade A, in 1(0.3%) patient we observed Grade B liver failure. We did not observe any Grade C hepatic failure. In patients with hepatic failure we observed significantly longer period of hospitalization ( p =0.007). Old age (Odds ratio=1.065, 95% confidince interval, 1.135-29.108, p=0.035), and peroperatory red blood cell (RBC) transfusion (Odds ratio=5.749, 95% confidince interval,1.019-1.113, p =0.005), were shown as independent risk factors for PHLF. Conclusion Posthepatectomy liver failure, is a vital complication of RDH. The risk can be decreased by careful selection of donor candidates. Old age donor candidates and intraoperative RBC are independent risk factors for PHLF.