성인간 생체 부분 간이식수술에서의 간공여자의 안전성
Safety of Donor in Adult-to-Adult Living Donor Liver Transplantation
조성호, 이승규, 이영주, 황신, 박광민, 안철수, 최동락, 주선형, 전장용, 박동은, 민병철,
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조성호 ( Jo Sung-Ho )
울산대학교 의과대학 서울중앙병원 외과학교실
이승규 ( Lee Sung-Gyu )
울산대학교 의과대학 서울중앙병원 외과학교실
이영주 ( Lee Young-Joo )
울산대학교 의과대학 서울중앙병원 외과학교실
황신 ( Hwang Shin )
울산대학교 의과대학 서울중앙병원 외과학교실
박광민 ( Park Kwang-Min )
울산대학교 의과대학 서울중앙병원 외과학교실
안철수 ( Ahn Chul-Soo )
울산대학교 의과대학 서울중앙병원 외과학교실
최동락 ( Choi Dong-Lak )
울산대학교 의과대학 서울중앙병원 외과학교실
주선형 ( Joo Sun-Hyung )
울산대학교 의과대학 서울중앙병원 외과학교실
전장용 ( Jun Jang-Yong )
울산대학교 의과대학 서울중앙병원 외과학교실
박동은 ( Park Dong-Yeun )
울산대학교 의과대학 서울중앙병원 외과학교실
민병철 ( Min Pyung-Chul )
울산대학교 의과대학 서울중앙병원 외과학교실
KMID : 0371320010600030314
Abstract
Purpose: Right lobe donation was advocated to overcome size-mismatch between left lobe and larger-size recipient in living donor liver transplantation (LDLT), however, safety of donor is a major concern. The purpose of this study is to evaluate the safety of donor in adult-to-adult LDLT.
Methods: Retrospective analysis of 104 adult-to-adult LDLT was performed by comparison of left lobectomy (n=50) and right lobectomy (n=54) groups.
Results: The median age of donors was 28 years and offsprings were most common donors (33.7%). The right lobe graft provided larger mass by 60% than left lobe. The ratio of residual liver volume to total liver volume, operation time, intraoperative blood loss, and postoperative ICU stay showed significant differences in both groups. Recovery of liver profiles was delayed by several days in right lobectomy group, but all donors recovered uneventfully. There was no mortality nor sequela in both groups. Severe postoperative complications occured more frequently in right lobectomy group, and they were bile leakage (n=3), postoperative bleeding (n=5), and portal vein thrombosis (n=1). All complications were controlled with safety.
Conclusion: Right lobe harvesting can be safe but should be performed only by expert operators because there is potential operative risk. To minimize operative complications, attention should be paid to every step of procedures and to postoperative surveillance.
키워드
성인간 생체 부분 간이식수술;간공여자의 안전성;간우엽 절제술
Adult-to-adult LDLT;Safety of donor; Right lobectomy
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