Liver transplantation (LT) has become a popular option for the treatment of endstage hepatic failure. More attention has been given to donor safety, but still no standardized protocol for the pre-operation stage of the donor to guarantee the donor's safety exists. The aim of this study is to share the findings of our center's cases of aborted hepatectomy(AH) during LT and help establish a reasonable protocol for LT with respect to the distribution of grafts and the selection of an appropriate candidate for living donor.

We reviewed all 1601 LT cases retrospectively and found 16 (1%) cases of AH from 1996 to March 2015. 14 (87.5%) of 16 cases were living donor liver transplantation(LDLT); 11 (68.8%) were canceled due to causes related to the recipient including peritoneal seeding, hemodynamic instability, intraabdominal inflammation, and severe adhesions, and 5 (31.2%) were canceled due to steatosis of the donor's liver.

Five recipients had peritoneal seeding of hepatocellular carcinoma and two recipients had severe bowel inflammation which were not proven by pre-operational imaging. Three recipients were too hemodynamically unstable to be kept under general anesthesia. One patient who underwent multiple transcatheter arterial chemoembolizations (TACE) and surgeries had severe adhesions, and the liver could not be approached.

Donor 1 who had severe fatty liver on preoperative abdominal ultrasound (US) showed macrovesicular and microvesicular steatosis of 40% and 50% respectively on intraoperation biopsy. Donor 2 had moderate fatty liver on preoperative US, and underwent recent weight loss. Intraoperational liver biopsy showed macrovesicular and microvesicular steatosis of 30% and 40% respectively. Donors 3 and 4 had only mild fatty liver, and Donor 5 had a normal sonogram; however, because of the intraoperational liver biopsy results, the livers of these donors were considered unsuitable for donation.

In conclusion, the only reason for the donors' AH was steatosis. US or computed tomography may be used to diagnose steatosis of the liver, but they are not useful for precise evaluation of the severity of liver steatosis in living donors. Moreover, no suitable non-invasive investigations are available. Through sharing our center's experience, we aim to establish a standardized protocol for managing living donors that prevents cases of AH, thereby reducing the economic, psychological, and physiologic burden of liver donors and recipients.

CITATION INFORMATION: Lee J, Choi G, Cho W, Joh J.-W, Lee S.-K, Kim S.-J, Kwon C, Park J, Kim J. Review of Aborted Hepatectomy of Liver Transplantation in a Single Center Study. Am J Transplant. 2016;16 (suppl 3).

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