PMID- 16172298
OWN - NLM
STAT- MEDLINE
DCOM- 20051101
LR  - 20050920
IS  - 0004-0010 (Print)
IS  - 0004-0010 (Linking)
VI  - 140
IP  - 9
DP  - 2005 Sep
TI  - Morbidity in live liver donors: standards-based adverse event reporting further 
      refined.
PG  - 888-95; discussion 895-6
AB  - HYPOTHESIS: The true extent of morbidity among live liver donors remains poorly 
      understood. In this unique and often high-profile area of surgery, the 
      development of standards for defining and reporting complications would foster a 
      better understanding of the incidence and magnitude of such adverse events (AEs). 
      DESIGN: Retrospective review of AEs among live liver donors. SETTING: 
      University-affiliated teaching hospital. PATIENTS AND METHODS: Of 202 individuals 
      undergoing evaluation for live liver donation, 42 (20.8%) proceeded to surgery. 
      Thirty-four underwent a right lobectomy without the middle hepatic vein; 3, a 
      left lateral segmentectomy. Any event causing a deviation from a patient's ideal 
      course was considered an AE and subsequently classified according to a derived 
      framework. Morbidity was defined as 1 or more AEs. MAIN OUTCOME MEASURES: 
      Incidence, timing, type, severity, and impact of AEs. RESULTS: No deaths or 
      significant hepatic dysfunction occurred. In 5 (12%) of the 42 donors, the 
      hepatectomy was aborted for anatomic reasons before parenchymal transection. 
      Eight (22%) of the remaining 37 experienced 11 AEs, of which 10 completely 
      resolved, whereas 1 AE (3%) resulted in a permanent disability (brachial 
      plexopathy). The overall incidence of AEs was 0.30 per case. Ten (91%) of the 11 
      AEs presented within the first postoperative month. CONCLUSIONS: Most live liver 
      donations are uncomplicated or do not lead to permanent consequence. The adoption 
      of a standards-based classification framework for AEs in live liver donors would 
      allow for an inclusive, consistent, and universally applicable method to collect, 
      analyze, and report donor morbidity.
FAU - Shackleton, Christopher R
AU  - Shackleton CR
AD  - Center for Liver Diseases and Transplantation, Cedars-Sinai Medical Center, and 
      Department of Surgery, The David Geffen School of Medicine at UCLA, USA. 
      shackletonc@thelivercenter.org
FAU - Vierling, John M
AU  - Vierling JM
FAU - Nissen, Nicholas
AU  - Nissen N
FAU - Martin, Paul
AU  - Martin P
FAU - Poordad, Fred
AU  - Poordad F
FAU - Tran, Tram
AU  - Tran T
FAU - Colquhoun, Steven D
AU  - Colquhoun SD
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Arch Surg
JT  - Archives of surgery (Chicago, Ill. : 1960)
JID - 9716528
SB  - IM
MH  - Adult
MH  - Female
MH  - *Hepatectomy
MH  - Humans
MH  - Liver Transplantation
MH  - *Living Donors
MH  - Male
MH  - Middle Aged
MH  - *Postoperative Complications
MH  - Retrospective Studies
MH  - Risk Management/*standards
EDAT- 2005/09/21 09:00
MHDA- 2005/11/03 09:00
CRDT- 2005/09/21 09:00
PHST- 2005/09/21 09:00 [pubmed]
PHST- 2005/11/03 09:00 [medline]
PHST- 2005/09/21 09:00 [entrez]
AID - 140/9/888 [pii]
AID - 10.1001/archsurg.140.9.888 [doi]
PST - ppublish
SO  - Arch Surg. 2005 Sep;140(9):888-95; discussion 895-6. doi: 
      10.1001/archsurg.140.9.888.