This is publication number 8 of the Adult-to-Adult Living Donor Liver Transplantation Cohort Study.
Recipient Morbidity After Living and Deceased Donor Liver Transplantation: Findings from the A2ALL Retrospective Cohort Study†
Article first published online: 27 OCT 2008
© 2008 The Authors Journal compilation © 2008 The American Society of Transplantation and the American Society of Transplant Surgeons
American Journal of Transplantation
Volume 8, Issue 12, pages 2569–2579, December 2008
How to Cite
Freise, C. E., Gillespie, B. W., Koffron, A. J., Lok, A. S. F., Pruett, T. L., Emond, J. C., Fair, J. H., Fisher, R. A., Olthoff, K. M., Trotter, J. F., Ghobrial, R. M., Everhart, J. E. and and the A2ALL Study Group (2008), Recipient Morbidity After Living and Deceased Donor Liver Transplantation: Findings from the A2ALL Retrospective Cohort Study†. American Journal of Transplantation, 8: 2569–2579. doi: 10.1111/j.1600-6143.2008.02440.x
- Issue published online: 11 NOV 2008
- Article first published online: 27 OCT 2008
- Received 21 December 2007, revised 20 August 2008 and accepted for publication 27 August 2008.
- learning curve;
- liver transplant;
- living donor;
Patients considering living donor liver transplantation (LDLT) need to know the risk and severity of complications compared to deceased donor liver transplantation (DDLT). One aim of the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL) was to examine recipient complications following these procedures. Medical records of DDLT or LDLT recipients who had a living donor evaluated at the nine A2ALL centers between 1998 and 2003 were reviewed. Among 384 LDLT and 216 DDLT, at least one complication occurred after 82.8% of LDLT and 78.2% of DDLT (p = 0.17). There was a median of two complications after DDLT and three after LDLT. Complications that occurred at a higher rate (p < 0.05) after LDLT included biliary leak (31.8% vs. 10.2%), unplanned reexploration (26.2% vs. 17.1%), hepatic artery thrombosis (6.5% vs. 2.3%) and portal vein thrombosis (2.9% vs. 0.0%). There were more complications leading to retransplantation or death (Clavien grade 4) after LDLT versus DDLT (15.9% vs. 9.3%, p = 0.023). Many complications occurred more commonly during early center experience; the odds of grade 4 complications were more than two-fold higher when centers had performed ≤20 LDLT (vs. >40). In summary, complication rates were higher after LDLT versus DDLT, but declined with center experience to levels comparable to DDLT.