Background: Living donor liver transplantation remains the predominant option for patients with acute or chronic liver failure in many regions with poor cadaveric donation rates. Over the years, the donor mortality and donor liver failure has been minimized due to improvement in selection and surgical expertise. However like any major liver resections, the risk of bleeding, reoperations and readmissions remains. Aim: Analysis of Reoperation and Readmission rates following Living Donor Hepatectomy from a single center from Western India. Methods: Retrospective analysis of records of living donors who required re-exploration and / or readmissions after Living donor hepatectomy performed between April 2013 & October 2016 at a single center. Results: 137 Donor hepatectomies were done during this period (121 Right Liver grafts and 16 Left lobe and Left lateral segment grafts). The mean age of Donors was 36 years (20 to 58) with a male preponderance ( M/F :1.6/1). There was no mortality (30 day and 90 day) and none of the donors had post-operative liver failure. Reoperation: 3 donors of right lobe grafts required early re-exploration (all for post op bleeding) within 24 hours of surgery. All 3 donors had undergone an uncomplicated intraoperative course. The site of bleeding in 2 patients was bile duct stump and RHV stump suture line in 1. One patient required surgery for ventral hernia 5 weeks later. Overall re-exploration rate was (2.1% at 30 day and 2.9% at 3 mth). There was no correlation between risk of reoperation and donor age, gender or remnant volume. All 3 patients who were explored for bleeding had a subsequent smooth recovery. Readmission: 2 patients, both right lobe donors, required readmission within 30 days for fluid collections- managed with percutaneous drainage. One patient was admitted after 5 weeks with incisional hernia that was managed surgically. The overall readmission rate was 1.4% at 30 days and 2% at 3mths. Conclusions: In experienced centers, living donor hepatectomy can be performed with zero mortality and low complications. The risk of re-exploration and readmissions is low, however each center needs to inform the donors especially right lobe donors about these potential outcomes.

CITATION INFORMATION: Kapoor S, Nath B, Varma V, Sable S, Chauhan A, Kumaran V. Readmission and Reoperation After Living Donor Hepatectomy. Am J Transplant. 2017;17 (suppl 3).

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