Session Time: 3:15pm-4:45pm
Presentation Time: 3:15pm-3:27pm
*Purpose: Living liver donation in Western nations permits a valuable expansion of the donor pool beyond the majority of deceased donors, whilst conversely providing the lifeline for liver transplantation activity in the East. The utilization of multi-organ living donors serves as a means to further increase the yield of living donation activity and is well recognized in the context of sequential liver-kidney donors. However the donation of liver allografts following earlier kidney donation is sporadic and not well described. The main concerns posed in such instances center on the risk of postoperative kidney injury. We elaborate on our institutional experience in this respect.
*Methods: The records of all living liver donations done at Cleveland Clinic from 2010 onwards were retrospectively reviewed to identify sequential kidney-liver donors. Pertinent clinical data was extracted. All living donors since 2012 have undergone formal MeVis ® 3D liver volumetry with vascular inflow/outflow precision visualization as part of their pre-operative work up, using Computerized Tomographic reconstruction. Postoperative renal function was serially monitored.
*Results: Five patients (amongst a total of 104 cases) underwent open living liver donation following earlier kidney donation. Donor characteristics are summarized in Table 1. Four of these patients (80%) pursued non-directed (altruistic) donation. The median interval between sequential donations was 4.5 years whereas median follow up after liver donation was 1 year. No significant postoperative complications were encountered in any instances and no significant impact on postoperative renal function was observed. eGFR trends in these donors are shown in Figure 1. Two left lateral section grafts were donated to pediatric patients whereas 3 left lobe grafts were given to adult recipients.
*Conclusions: Our series serves to highlight the feasibility of living liver donation following earlier donor nephrectomy through the minimization of donor risk by the utilization of left-sided grafts.
To cite this abstract in AMA style:Nair A, Sasaki K, Uso TDiago, Fujiki M, Eghtesad B, Kwon D, Aucejo F, Quintini C, Miller C, Hashimoto K. Living Liver Donation in Previous Kidney Donors – A Valuable Resource for Hepatic Allografts without Compromising Donor Safety [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/living-liver-donation-in-previous-kidney-donors-a-valuable-resource-for-hepatic-allografts-without-compromising-donor-safety/. Accessed October 26, 2020.
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