Purpose: Donor hepatectomy for living donor liver transplantation accompanies physiomorphological changes of the liver and the spleen. Therefore, the long-term consequences of these organs should be characterized to ensure donor safety. Methods: A total of 382 right liver harvests for liver transplantation were performed at a single institution from October 2000 to February 2011. Clinical parameters, including remaining liver volume, splenic volume, and platelet count across donor operations were compared, and the associations were investigated. Results: The remaining liver grew continually, reaching 81.5 ± 11.2% of the entire liver until 6 months after donation. In contrast, although the spleen grew to 143.1 ± 28.8% of the pre-donation value within 1 week after surgery, its size decreased gradually to 130.6 ± 25.1% of the pre-donation value at 6 months post-donation. Platelet count decreased to 85.3 ± 11.2% at 1 week after donation, and the reduction was maintained until 6 months post-donation without a significant difference. At 6 months post-donation, 48.1% (114/237) of donors showed an increase of ≥ 30% in splenic volume, and 15.9% (50/315) of donors exhibited a decrease of ≥ 30% in platelet count compared to pre-donation values. However, patients with thrombocytopenia and/or splenomegaly at 6 months post-donation were not different in liver function, liver regeneration, or overall complications. Conclusion: Although splenomegaly and/or thrombocytopenia can persist for more than 6 months after donation in some patients, such a change did not impact donor safety.

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