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| Impact of intra-operative cholangiography and parenchymal resection to donor liver function in living donor liver transplantation |
| Feng Gao, Xiao Xu, Yang-Bo Zhu, Qiang Wei, Bin Zhou, Xiao-Yong Shen, Qi Ling, Hai-Yang Xie, Jian Wu, Wei-Lin Wang and Shu-Sen Zheng |
Hangzhou, China
Author Affiliations: Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery (Gao F, Xu X, Zhu YB, Wei Q, Ling Q, Wu J, Wang WL and Zheng SS), Department of Radiology (Shen XY), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases (Gao F, Xu X, Ling Q, Xie HY, Wu J, Wang WL and Zheng SS), Key Lab of Combined Multi-Organ Transplantation, Ministry of Public Health (Xie HY and Zheng SS), First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; and Department of General Surgery, The Second Hospital of Ningbo City, Ningbo 315502, China (Zhou B)
Corresponding Author: Shu-Sen Zheng, MD, PhD, FACS, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou 310003, China (Tel/Fax: 86-571-87236567; Email: zyzss@zju.edu.cn) |
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Abstract BACKGROUND: Living donor liver transplantation (LDLT) has been widely accepted over the past decade, and hepatic dysfunction often occurs in the donor in the early stage after liver donation. The present study aimed to evaluate the effect of intra-operative cholangiography (IOC) and parenchymal resection on liver function of donors in LDLT, and to assess the role of IOC in influencing the biliary complications and improving the overall outcome.
METHODS: Data from 40 patients who had donated their right lobes for LDLT were analyzed. Total bilirubin (TB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and γ-glutamyl transpeptidase (GGT) at different time points were compared, and the follow-up data and the biliary complications were also analyzed.
RESULTS: The ALT and AST values were significantly increased after IOC (P<0.001) and parenchymal resection (P<0.001). However, the median values of TB, ALP and GGT were not significantly influenced by IOC (P>0.05) or parenchymal resection (P>0.05). The biochemical changes caused by IOC or parenchymal resection were not correlated with the degree of post-operative liver injury or the recovery of liver function. The liver functions of the donors after operation were stable, and none of the donors suffered from biliary stenosis or leakage during the follow-up.
CONCLUSIONS: IOC and parenchymal resection may induce a transient increase in liver enzymes of donors in LDLT, but do not affect the recovery of liver function after operation. Moreover, the routine IOC is helpful to clarify the division line of the hepatic duct, thus reducing the biliary complication rate.
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2014, Vol. 13 
