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Article first published online: 21 DEC 2011
Copyright © 2011 American Association for the Study of Liver Diseases
Volume 18, Issue 1, pages 129–137, January 2012
How to Cite
Park, J. B., Joh, J.-W., Kim, S.-J., David Kwon, C.-H., Min Chun, J., Man Kim, J., Ik Moon, J. and Lee, S.-K. (2012), Effect of intermittent hepatic inflow occlusion with the Pringle maneuver during donor hepatectomy in adult living donor liver transplantation with right hemiliver grafts: A prospective, randomized controlled study. Liver Transpl, 18: 129–137. doi: 10.1002/lt.22409
This randomized clinical trial was registered at ClinicalTrials.gov (NCT01171742).
This study was funded by the Clinical Research Development Program (CRS1091811).
- Issue published online: 21 DEC 2011
- Article first published online: 21 DEC 2011
- Accepted manuscript online: 11 AUG 2011 09:32AM EST
- Manuscript Accepted: 3 AUG 2011
- Manuscript Received: 29 NOV 2010
- ClinicalTrials.gov. Grant Number: NCT01171742
- Clinical Research Development Program. Grant Number: CRS1091811
To evaluate the effects of intermittent hepatic inflow occlusion (IHIO) during donor hepatectomy for living donor liver transplantation (LDLT) in recipients and donors, we performed a single-center, open-label, prospective, parallel, randomized controlled study. Adult donor-recipient pairs undergoing LDLT with right hemiliver grafts were randomized into IHIO and control groups (1:1). In the IHIO group, IHIO was performed during donor hepatectomy. The primary endpoint was the peak serum alanine aminotransferase (ALT) concentration in the recipients within 5 days after the operation. Blood samples for measurements of interleukin-6 (IL-6), IL-8, tumor necrosis factor α (TNF-α), and hepatocyte growth factor (HGF) were taken from the donors and the recipients during the operation and postoperatively. Biopsy samples for measurements of caspase-3 and malondialdehyde (MDA) were taken from the donors and the recipients. In all, 50 donor-recipient pairs (ie, 25 pairs in each group) completed this study. The mean peak serum ALT levels within 5 days after the operation did not differ in the recipients between the 2 groups (P = 0.32) but were higher in the donors of the IHIO group (P = 0.002). There were no differences in the prothrombin times or total bilirubin levels in the recipients or donors between the 2 groups. The amount of blood loss during donor hepatectomy was significantly lower in the IHIO group versus the control group (P = 0.02). The mean hospital stay for donors was 19.3 ± 7.2 days in the control group and 15.8 ± 4.6 days in the IHIO group (P = 0.046). There were no in-hospital deaths within 1 month and no cases of primary nonfunction or initially poor function in the 2 groups. The concentrations of IL-6, IL-8, TNF-α, and HGF did not differ between the 2 groups, nor did the concentrations of caspase-3 and MDA. In conclusion, although we found differences in postoperative peak serum ALT levels in donors, donor hepatectomy with IHIO for LDLT using a right hemiliver graft with a graft-to-recipient body weight ratio > 0.9% and <30% steatosis can be a tolerable procedure for donors and recipients. Liver Transpl 18:130–138, 2012. © 2011 AASLD.