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Invited Critique
September 1, 2005

Morbidity in Live Liver Donors—Invited Critique

Arch Surg. 2005;140(9):896. doi:10.1001/archsurg.140.9.896

This article reports on a retrospective review of AE among live liver donors in a university-affiliated teaching hospital. Thirty-four patients underwent right lobectomy while 3 had a left-lateral segmentectomy. Any event causing a deviation from a patient’s ideal course was considered an AE, and the incidence, timing, type, severity, and impact of AEs were studied. The purpose of the current report is first, to review, analyze, and report morbid events related to the live liver donor process in a consecutive series from the authors’ center, and second, to apply a further derivation of an AE classification framework to provide an additional step toward the development of standards-based morbidity reporting. Shackleton et al found no deaths or significant hepatic dysfunction in the live donor patients. In 5 (11.9%) of 42 patients, the hepatectomy was aborted for anatomic reasons prior to proceeding with the liver resection. Eight (21.6%) of the remaining 37 experienced 11 AEs, of which 10 completely resolved. The overall incidence of AEs was 0.3 per case. The authors conclude that (1) the majority of live liver donations are either uncomplicated or do not lead to permanent consequence, and (2) the adoption of a standards-based classification framework for AEs in live liver donors should allow for an inclusive, consistent, and universally applicable method to collect, analyze, and report donor morbidity.