Analysis of surgical and perioperative complications in seventy-five right hepatectomies for living donor liver transplantation

Table 1 Demographic, anatomic and surgical characteristics of 75 RHLD (mean ± SD)

Characteristics	n	Percent (%)
Age		32.27 ± 9.29
Range		[18;54]
Classes
0-20	6	8
21-40	53	70.67
41-60	16	21.33
Sex
Male	35	46.67
Female	40	53.33
Height (cm)		169.05 ± 8.86
Weight (kg)		68.19 ± 11.79
Donor relationship
Biologically related	65	86.67
Sibling	10	13.33
Child	51	68.00
Parent	4	5.33
Not biologically related	10	13.33
Spouse	5	6.67
Other nonbiological	5	6.67
Donors
ICU length of stay (d)
Average		1.66
Range		[1;5]
Total length of stay (d)
Average		8.26
Range		[6;14]
Length of donor surgery (h)		7.90 ± 1.75
Graft weight (g)		784.57 ± 158.15
GRBWR		1.43 ± 0.44
Bile ducts
Double bile ducts	50	67
Single bile duct	25	33
Hepatic veins
1	58	77
2	17	23
Hepatic arteries
1	73	97
2	2	3
Portal veins
1	65	87
2	10	13

GRBWR: Graft to recipient body weight ratio; ICU: Intensive care unit.

Table 2 Classification of surgical complications in RHLD

Patients ID	Complications/Treatment	Classification of surgical complications Clavien annals of surgery 2004	Frequency (%) of complication for every classification grade
1	JP retained in the abdomen/Relaparotomy	Grade IIIb	13.04
2	Edema, ascites/None	GradeI	21.74
3	Prolonged hyperbilirubinemia/None	GradeI
4	Fluid collection/Percutaneous drainage	Grade IIIa	17.39
5	Biliary leak /ERCP with stent placement	Grade IIIb, d	21.74
6	Transient portal vein thrombosis/Enoxaparin	Grade II	13.04
7	Bilateral massive pleural effusion/Percutaneous drainage	Grade IIIa
8	Colitis by CD/Metronidazole	Grade II
9	Biliary leak/ERCP (stent placement)	Grade IIIb, d
10	Mild pleural effusion/None	GradeI
11	Intrabdominal fluid collection/Percutaneous drainage	Grade IIIa
12	JP retained in the abdomen/Relaparotomy	Grade IIIb
13	Intrabdominal fluid collection; biliary leak/Percutaneous drainage; ERCP (sphincterotomy)	Grade IIIb
14	Intrabdominal fluid collection; biliary leak/Percutaneous drainage; ERCP (sphincterotomy and stent placement)	Grade IIIb, d
15	Intrabdominal fluid collection/Percutaneous drainage	Grade IIIa
16	Prolonged hyperbilirubinemia/None	GradeI
17	Intraabdominal fluid collection; Biliary leak/Percutaneous drainage, ERCP (sphincterotomy, stent placement X 3, acute pancreatitis, PTBD placement)	Grade IIIb, d/Grade IV	4.35
18	Pulmonary embolism and iliac vein thrombosis/Anticoagulation	Grade IV	4.35
19	Moderate pleural effusion; intraabdominal fluid collection/Percutaneous drainage; percutaneous drainage	Grade IIIa- Grade IIIa, d	4.35
20	Biliary leak/ERCP (Sphincterotomy, endoscopic stent placement failure); PTBD	Grade IIIb, d
21	Intraabdominal fluid collection; biliary leak, moderate pleural effusion/Percutaneous drainage; ERCP (sphincterotomy, endoscopic stent placement); percutaneous drainage	Grade IIIb, d
22	Prolonged hyperbilirubinemia/None	GradeI
23	Fever/Antibiotic treatment	Grade II

Table 3 CT scan calculated donors mean liver volume (mean ± SD)

CT scan calculated
Total liver volume	Right lobe volume	Remnant liver volume
1538.94 ± 277	954.67 ± 219.6	584.28 ± 121.67
CT scan calculated right lobe volume 2 mo after surgery into the recipient	CT scan calculated remnant liver volume 2 mo after surgery
	1511.60 ± 257.88	1065.08 ± 195.24
	98% regeneration	69% regeneration

Table 4 Distribution of anatomic variations in the complicated and uncomplicated groups of RHLD, n (%)

Anatomic variations	23 complicated RHLD	54 RHLD without complications	P value
Double bile ducts	15 (65.21)	36 (66.67)
Single bile duct	8 (34.78)	18 (33.33)	0.78
Hepatic veins
Single	21 (91.30)	39 (72.22)
Double	2 (8.69)	15 (27.78)	0.09
Hepatic arteries
Single	22 (95.65)	53 (98.15)
Double	1 (4.34)	2 (1.85)	0.82
Portal veins
Single	20 (86.95)	46 (85.19)
Double	3 (13.04)	8 (14.81)	0.54

Table 5 CT scan calculated donors mean liver volume in the complicated and uncomplicated groups of RHLD (mean ± SD)

	23 complicated RHLD	54 RHLD without complications	P value
CT scan calculated total liver volume	1517.7 ± 292.4	1547.20 ± 292.43	0.68
CT scan calculated right lobe volume	957.67 ± 226.37	953.50 ± 219.16	0.94
CT scan calculated remnant liver volume	560.05 ± 89.19	593.70 ± 131.69	0.28
CT scan calculated remnant liver volume 2 mo after surgery	1078.6 ± 201.65	1059.57 ± 194.42	0.72