Diaphragmatic herniation following donor hepatectomy for living donor liver transplantation : a serious complication not given due recognition :a serious complication not given due recognition

Rajiv Lochan; Rehan Saif; Naveen Ganjoo; Mallikarjun Sakpal; Charles Panackal; Kaiser Raja; Jayanth Reddy; Sonal Asthana; Mathew Jacob

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저자정보: Rajiv Lochan (Aster CMI Hospital) Rehan Saif (Aster MedCity Hospital) Naveen Ganjoo (Aster MedCity Hospital) Mallikarjun Sakpal (Aster CMI Hospital) Charles Panackal (Aster CMI Hospital) Kaiser Raja (Aster CMI Hospital) Jayanth Reddy (Aster CMI Hospital) Sonal Asthana (Aster CMI Hospital) Mathew Jacob (Aster MedCity Hospital)

저널정보: 한국간담췌외과학회 Annals of Hepato-Biliary-Pancreatic Surgery 한국간담췌외과학회지 제21권 제4호

발행연도: 2017.11

수록면: 232 - 236 (5page)

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A clear appreciation of benefits and risks associated with living donor hepatectomy is important to facilitate counselling for the donor, family, and recipient in preparation for living donor liver transplant (LDLT). We report a life-threatening complication occurring in one of our live liver donors at 12 weeks following hemi-liver donation. We experienced five donor complications among our first 50 LDLT: Clavien Grade 1, n=1; Clavien grade 2, n=3; and Clavien grade 3B, n=1. The one with Clavien grade 3B had a life-threatening diaphragmatic hernia occurring 12 weeks following hepatectomy. This was promptly recognized and emergency surgery was performed. The donor is well at 1-year follow-up. Here we provide a review of reported instances of diaphragmatic hernia following donor hepatectomy with an attempt to elucidate the pathophysiology behind such occurrence. Life-threatening donor risk needs to be balanced with recipient benefit and risk on a tripartite basis during the counselling process for LDLT. With increasing use of LDLT, we need to be aware of such life-threatening complication. Preventive measures in this regard and counselling for such complication should be incorporated into routine work-up for potential live liver donor.

#Minimizing donor risk #Living liver donor hepatectomy #Liver transplantation #Diaphragmatic hernia

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