The increasing popularity of live donor adult liver transplantation underscores the need for careful evaluation of potential donors. In April in Archives of Surgery, Elizabeth A. Pomfret, MD, PhD, of the Lahey Clinic Medical Center and colleagues reported that "significant donor morbidity is encountered even with careful selection" (2001;136:425-433).
In the 16 months spanning December 1998 and April 2000, the authors screened and evaluated 66 potential living liver donors. The process resulted in 15 live donor adult liver transplants. Thirty-two potential donors were rejected; nine more were accepted and were awaiting transplantation; and ten elected not to participate after their initial interview with a transplant surgeon.
In 12 of the 32 rejected donors, either the recipient became too ill before transplantation could be performed or the recipient died. Five rejected donors had livers that were too small to be considered for transplantation.
"Given the potential risk of harm to the donor, such procedures should be limited to centers with demonstrated excellence in complicated hepatobiliary surgery and established liver transplant programs," the authors reported.
The paper was based on findings the authors presented in October 2000 at the 81st Annual Meeting of the New England Surgical Society. The paper includes a transcript of the discussion that took place at the meeting.
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The abstract is posted at http://archsurg.ama-assn.org/issues/current/abs/sne0009.html.
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