Liver transplantation from live donors was developed in the late 1980s; deaths of living donors have been reported in western countries, but no detailed analysis has been done in Japan, where this type of transplantation has been done since 1989.
Morito Monden and colleagues (on behalf of the Japanese Liver Transplantation Society) assessed data for illness and mortality around the time of transplantation among 1841 live donors from 46 transplant centres. 12% of donors had complications around the time of surgery; these were more common and lead to increased hospital stay for donors of the right lobe (average 20 days hospitalisation) compared with donors of the left lobe or lateral segment (average 14 days hospitalisation for both groups).
Morito Monden comments: "At the time of our survey, no perioperative mortality was recorded in living donors in Japan. However, a proportion of these donors developed serious complications. Unfortunately, one of our donors has since died, having donated her right liver lobe to her daughter. We should make every effort to reduce the morbidity and mortality in living donors."
An accompanying Commentary (p 674) by Owen Surman and Martin Hertl from Massachusetts General Hospital, Boston, USA discusses how more attention needs to be focused on the well-being of live donors. They conclude: "In the end we must rely on other avenues for treatment of organ failure, but until such time, careful selection of the donor and keeping in mind that donor safety over-rides benefit for the recipient has to be the "credo" of the transplant team."
Contact: Dr. Morito Monden, Department of Surgery & Clinical Oncology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita Osaka 565-0871 Japan; T) 81-6-6879-3251; F) 81-6-6879- 3259; E) monden@surg2.med.osaka-u.ac.jp.
Dr. Owen Surman, Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA; E) osurman@partners.org.
Journal
The Lancet