Effect of Donor Right Hepatectomy on Splenic Volume and Platelet Count for Living Donor Liver Transplantation

• Published in: Journal of gastrointestinal surgery Vol. 17; no. 9; pp. 1576 - 1583
• Main Authors: Kim, Say-June, Na, Gun-Hyung, Choi, Ho-Joong, You, Youngkyoung, Kim, Dong-Goo
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.09.2013; Springer Nature B.V
• Subjects: Abdomen; Adolescent; Adult; Aged; Biopsy; Female; Follow-Up Studies; Gastroenterology; Hepatectomy; Hospitals; Humans; Liver; Liver Regeneration; Liver Transplantation; Living Donors; Male; Medicine; Medicine & Public Health; Middle Aged; Morphology; Original Article; Outcome Assessment, Health Care; Patients; Postoperative Complications - epidemiology; Retrospective Studies; Spleen; Splenomegaly - epidemiology; Splenomegaly - etiology; Surgery; Thrombocytopenia - epidemiology; Thrombocytopenia - etiology; Young Adult; South Korea; Thrombocytopenia; Donor hepatectomy; Liver regeneration; Splenic enlargement; Living donor liver transplantation
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-013-2219-0

Background Donor hepatectomy for living donor liver transplantation accompanies physio-morphological changes of the liver and spleen. Therefore, the long-term consequences of these organs should be characterized to ensure donor's safety. Methods A total of 382 right liver harvests for liver transplantation were performed from October 2000 to February 2011. Clinical parameters across donor operations were compared, and the associations were investigated. Results The remaining liver grew continually, reaching 81.5 ± 11.2 % of the entire liver until 6 months after donation. The spleen grew to 143.1 ± 28.8 % of the pre-donation value within 1 week after surgery, and thereafter, its size decreased gradually to 130.6 ± 25.1 % at 6 months. At 6 months post-donation, 48.1 % (114/237) of donors showed an increase of ≥30 % in splenic volume, and 15.9 % (50/315) of donors exhibited a decrease of ≥30 % in platelet count. However, patients with splenic enlargement and/or decrease in platelet count at 6 months post-donation were not different in liver function, liver regeneration, or overall complications. Conclusions Although splenic enlargement and/or decrease in platelet count can persist for more than 6 months after donation in patient population after donor right hepatectomy, such a change did not impact donor's safety.