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Comparison of Right Lobe Donor Hepatectomy with Elective Right Hepatectomy for Other Causes in New York

Comparison of Right Lobe Donor Hepatectomy with Elective Right Hepatectomy for Other Causes in New York,10.1007/s10620-010-1489-6,Digestive Diseases a

Comparison of Right Lobe Donor Hepatectomy with Elective Right Hepatectomy for Other Causes in New York  
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Introduction  Right lobe donor hepatectomy (RLDH) is a potential source of liver allografts given the ongoing shortage of deceased donor organs available. Since there is no live donor registry in the United States, a population-based, unsolicited state-wide analysis has yet to be reported. Methods  The New York (NY) State Inpatient Database was used to query 1,524 elective liver lobectomies performed from 2001 to 2006. RLDH were identified in this cohort (n = 195; 13%). Most common indications for elective right lobe hepatectomy (ERH) were metastatic colon cancer (50%) and hepatocellular carcinoma (HCC) (34%). Primary outcomes were mortality, perioperative resources and major postoperative complications. Results  After a dramatic drop in 2002, there was a slow increase in RLDH from 2003 to 2006 in New York. Donors were younger (median age 36 vs. 60 years, P P < 0.0001) than patients undergoing ERH for other causes. Median length of hospital stay was 7 days in both groups. Donors were less likely to require blood transfusion (22.6 vs. 62.8%, P < 0.0001) and received less blood (mean 0.10 units vs. 2.4 units). Major post-operative complications based on the Clavien classification occurred in only 2.6% of donor cases compared to 13.8% in non-donors (P P = 0.003). Conclusions  This study represents one of the first unsolicited regional analyses of donor morbidity and resource utilization for RLDH and further emphasizes the need and utility of a live donor registry.
Journal: Digestive Diseases and Sciences - DIGEST DIS SCI , vol. 56, no. 6, pp. 1869-1875, 2011
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