Diagnostic and therapeutic treatment methods for intrathoracic extrapulmonary lipomas.

BACKGROUND: Lipomas are rarely seen tumors of adipose tissue that are benign in character. Although mostly located to the subcutaneous region, specifically in the upper back, neck, and shoulder, they may also occur in thoracic cavity. AIM: They aim of the study was to analyse clinical features and outcome of treatment of intrathoracic pleural lipomas. MATERIALS AND METHOD: We retrospectively evaluated the clinicopathological records of seven patients with intrathoracic lipomas who had undergone surgery between 2005 and 2017. We made analyses in terms of age, gender, admission complaints, lesion locations and dimensions, diagnostic techniques, operative procedures, histopathological features, and prognosis. RESULTS: Four women and three men with a mean age 62.7 (range, 48-75 years) were included. They had chest pain (n = 2), effort dyspnea (n = 1) as the admission symptom, whereas four patients were asymptomatic, whose lesions were detected on chest radiography on an incidental basis. The radiological features of the tumors were well-demarcated, homogenous lesions with fat density. Tumors of all cases were excised, which were located on the right side in two patients and left in five. We used video-assisted thoracoscopy in two patients, single-port video-assisted thoracoscopy in three patients, thoracotomy in two patients. All lesions were of parietal pleural origin and were located intrathoracically. They had a range of size between 4 and 10 cm, with an average of 6.7 cm. All cases were operated with complete resection. At a mean follow-up duration of 4.7 years no recurrence was noted. CONCLUSION: Intrathoracic lipomas are rare, benignly behaving tumors. As it may prove difficult to differentiate them from malignant lesions and they may grow in an invasive growth pattern, surgery should be pursued in all patients for both diagnosis and treatment.

Posttransplant Diabetes Mellitus Incidence and Risk Factors in Adult Liver Transplantation Recipients.

AIM: Posttransplant diabetes mellitus (PTDM) is a metabolic complication that usually occurs after liver transplantation (LT) due to immunosuppression. In this study, our aim was to identify PTDM incidence after LT in our center and the potential risk factors. MATERIALS AND METHODS: In this study, 238 adult LT patients were evaluated in terms of PTDM development. RESULTS: Of 238 patients included in the study, 170 (71.4%) were male, 68 (28.6%) were female and the mean age was 43.5± 13.7 years. Of all patients, PTDM developed in 24 (10.1%). Transient-Hyperglycemia (t-HG) was detected in 31 (13%) patients. PTDM and t-HG patients had a greater body weight than non-PTDM patients (BMI kg/m2: 27.6± 5.3, 25.8± 4.3and 23.9± 3.3, respectively p<0.001 p= 0.028). PTDM and t-HG patients mean age was higher than non-PTDM patients (51.5± 9.68, 48.2± 11.1 and 41.5± 14 years, respectively, p= 0.002 p= 0.023). In the univariate analysis, the only independent risk factor for PTDM was age (OR 1.93, 95% CI 1.31-2.97). CONCLUSION: Age is the most important risk factor for PTDM development after LT. PTDM was found more common in the patient group with greater body weight. Patients with older age and greater body weight should be examined more carefully for PTDM before LT.

Metastatic lung cancer associated with Warthin's tumour.

Warthin's tumors which can easily be subjected to misinterpretation are encountered commonly in clinical practice. Warthin's tumors which generally have the localization of parotid gland cauda and have a slow growing characteristic can rarely be seen aside from parotid gland; such as cervical lymph nodes and minor salivary glands. A 56-year-old patient's case that comprised atypical coexistence of Warthin tumor with PET/CT scan positive cervical lymph nodes during the diagnostic examination carried out for a pulmonary mass lesion is presented. While the transthoracic biopsy performed for the mass indicated non-small cell lung carcinoma, histopathologic diagnosis established for the lymph node reported Warthin tumor. Early detection of Warthin tumor may result in earlier diagnosis of lung cancer since patients with Warthin tumor have a higher risk of lung malignancy.

Results of surgical treatment of anterior abdominal wall desmoid tumours : 13 cases reviewed with literature.

BACKGROUND: We retrospectively evaluated the results of surgical treatment for anterior abdominal wall -desmoid tumours. METHODS: Records for 13 patients operated on for desmoid tumours from 1997-2013 were searched for age, gender, abdominal/pelvic surgical history, pregnancy, Gardner's syndrome, pre-operative radiological examinations, tumour size, multifocality, surgical procedure, tumour presence at surgical margins, recurrence, morbidity, and mortality. Local recurrence-free survival probabilities were estimated by the Kaplan-Meier method and stratified by various clinicopathological variables. RESULTS: There were 11 female (84,6%) and 2 male (15,4%) patients with a median age of 36 years. Seven (53,8%) -patients had previous abdominal/pelvic surgery, five (38,5%) had a history of pregnancy, and one (7,6%) had Gardner's Syndrome. Two (15,3%) patients had multifocality on their pre-operative radiological examinations. Mean tumour -diameter was 4,6 cm (SD 3,2 cm ; range 2-12 cm). After the excision of the masses in five (38,5%) patients, synthetic materials were used to close the abdominal wall defects. Two (15,3%) patients with positive surgical margins after -surgery were re-operated. Three (23%) patients required a second surgical intervention after the mass excisions were performed. Mean follow-up time was 56,7 months. Recurrence was observed in three patients during follow-up. Increased tumour size, history of previous abdominal/pelvic surgery, and the presence of multifocality had a negative effect on local recurrence-free survival. There was no mortality during follow-up. CONCLUSIONS: Desmoid tumours are characterized by high recurrence, even after proper surgical excisions. Preoperative differential diagnoses of these tumours should be done and a post-operative follow-up protocol should be followed.

Circadian rhythm of serum phosphate, calcium and parathyroid hormone levels in hemodialysis patients.

BACKGROUND: Serum levels of Phosphate (P), Calcium (Ca) and Parathyroid hormone (PTH) show circadian rhythms in healthy people. The aim of this study is to investigate whether there is also a rhythm in Hemodialysis (HD) patients. METHODS: We studied 15 (11 M, 4 F) HD patients, ages were 26 - 70 (mean 53 +/- 15) years. Two of the patients had history of parathyroidectomy operation. Serum levels of phosphate, calcium, albumin and PTH were evaluated six times at 07.00, 11.00, 15.00, 19.00, 23.00 and 03.00 on the second day after scheduled HD session. RESULTS: The lowest serum phosphate levels were found at 15.00 (5.41 +/- 1.76 mg/dL), the highest levels were 5.97 +/- 1.77 mg/dL at 03.00. The lowest serum Ca levels were 7.90 +/- 1.31 mg/dL at 03.00, the highest levels were 8.39 +/- 1.20 mg/dL at 15.00. Serum levels of PTH increased two times in a day and then decreased. The lowest levels were 330.07 +/- 203.57 pg/mL at 07.00, the highest levels were 418.30 +/- 206.24 pg/mL at 15.00. The results of two patients who had parathyroidectomy history disclosed that the lowest levels of phosphate were 2.87 +/- 0.12 mg/dL at 15.00, the highest levels were 4.37 +/- 1.25 mg/dL at 07.00. Serum Ca levels were as; the lowest levels: 8.29 +/- 3.5 mg/dL at 03.00, the highest levels 9.30 +/- 3.50 mg/dL at 19.00. As expected, serum PTH levels were constantly low during the day disclosing no correlation with other parameters. CONCLUSIONS: These results show that serum P, Ca and PTH levels exhibit a circadian rhythm also in HD patients. The rhythm predominantly depends on endogen factors and intravascular volume.

The effect of the psychological status of breast cancer patients on the short-term clinical outcome after mastectomy.

PURPOSE: to analyze the effect of anxiety and depression on the postoperative complications and length of hospitalization of patients with breast cancer. Beck's Depression Inventory (BDI) and Hospital Anxiety and Depression Scale (HADS) were filled out by the patients pre-operatively. Patients were asked to rate their pain by the visual analogue scale (VAS) after surgery. Age, seroma volume, day of drain withdrawal, complications, and pathological stages were noted. The median age of 49 patients with the diagnosis of breast cancer was 51 (36-80). There was a significant correlation between the pain score and Beck, HADS, HADS (anxiety) and HADS (depression) (8 hours ; p = 0.021, 0.001, 0.004, 0.005 and 24 hours ; p = 0.005, 0.012, 0.006, 0.120). The mean HADS depression score in those patients with complications was 9.1 +/- 4.2 and that of patients with no complications was 6.6 +/- 3.1 (p = 0.047). The mean hospital stay of patients with a normal HADS score (< 19) was 2.9 +/- 1.1 days, whilst that of patients with an abnormal HADS score was 3.8 +/- 1.2 days (p = 0.016). Patients with abnormal HADS anxiety and abnormal HADS (total) scores had an earlier stage of breast cancer (p = 0.077, p = 0.063). The psychological status of breast cancer patients effects their postoperative recovery period and it is easy to diagnose these patients by some brief questionnaires.

Multidetector computed tomography findings of spontaneous renal allograft ruptures.

AIM: To describe the characteristics of spontaneous renal allograft rupture using multidetector computed tomography (MDCT). METHOD: Five patients with spontaneous renal allograft rupture, as confirmed by pathologic examination, were referred to our institution between 1985 and 2008. The clinical records and preoperative MDCT findings of the patients were studied retrospectively. RESULTS: Clinical and/or histological findings were consistent with acute rejection in all cases. Using MDCT, disruption of the capsular integrity and parenchymal rupture was seen in four patients. Four of the five patients showed decreased enhancement and swollen grafts. Perirenal (n=4), subcapsular (n=1), and intraparenchymal (n=1) haematomas were also seen. In the patient with an intraparenchymal haematoma there was no disruption of capsular integrity, but capsular irregularities were seen near the haematoma. CONCLUSION: MDCT is a useful investigative tool for the evaluation of suspected spontaneous renal allograft rupture. As well as a swollen graft, disruption of the capsule, parenchyma, and/or haematoma should prompt the radiologist to consider this diagnosis.

Prevalence of cutaneous bacterial infections and nasal carriage of Staphylococcus aureus in recipients of renal transplants.

BACKGROUND: Renal transplant recipients (RTRs) often develop bacterial infections as a result of their long-term immunosuppressive treatment. However, there is no published case-control study of cutaneous bacterial infections in this population, and the prevalence of nasal Staphyloccus aureus carriage and its role in cutaneous bacterial infections in RTRs are not known. AIMS: To determine whether the prevalence of cutaneous bacterial infections and nasal S. aureus carriage are increased in RTRs and to investigate the association between nasal S. aureus carriage and cutaneous staphylococcal infections. METHODS: In total, 66 outpatient RTRs and 67 controls were investigated for the presence of cutaneous bacterial infections. Bacterial cultures were taken from clinically suspicious cutaneous lesions, and three nasal swabs were collected to detect nasal S. aureus colonization. RESULTS: Cutaneous bacterial infection was suspected in 42.4% of RTRs, and in 14.2% of controls. However, of the lesions that could be cultured, microbiologically proven cutaneous bacterial [methicillin-sensitive S. aureus (MSSA)] infections were confirmed in only two RTRs and one control subject. Nasal S. aureus carriage was found in 10.6% of RTRs and 29.9% of controls (P < 0.05). Both RTRs with MSSA infection were nasal carriers, whereas nasal S. aureus carriage was not detected in the only control subject with MSSA infection. All S. aureus isolates were oxacillin-sensitive. CONCLUSION: Screening for nasal S. aureus carriage does not seem to assist in preventing staphylococcal bacterial infections in outpatient RTRs.

Relationship of preoperative venous and arterial imaging findings to outcomes of brachio-basilic transposition fistulae for hemodialysis: a prospective clinical study.

PURPOSE: To evaluate the maturation and patency of transposed brachio-basilic fistulae that had been chosen based on the results of preoperative imaging techniques. METHODS: Among 215 patients admitted to our clinic requiring arteriovenous fistulae between May 2004 and September 2005, 59 were scheduled for a transposed brachio-basilic fistula procedure. The relationship between demographic data, laboratory values, invasive and noninvasive imaging studies with patency and maturation time of the fistulae were evaluated by univariate analyses. RESULTS: Primary and secondary patency rates were 82% and 97% at 6 months 72% and 92% at one year respectively. The only parameter found to affect maturation time was basilic vein diameter. The maturation time was 59.3+/-22.3 days (range 32-92 days) for veins less than 3mm in diameter and 24.7+/-4.4 days (range, 21 to 34 days) for those with larger diameters. The number of previously failed fistulae correlated with a decrease in primary patency time. The primary patency rate at 1 year was 58.9% for patients whose preoperative arterial flow rate was below 70cm/sec, while it was 93.3% when the flow was greater. CONCLUSION: We believe that this type of fistula should be the first option in patients in whom the cephalic vein is inappropriate for a vascular access. Preoperative evaluation of the arterial system as well as a history of previous access failure may be considered predictive parameters for the patency of the fistulae.

Malnutrition inflammation score is associated with coronary artery disease in hepatitis C virus-infected hemodialysis patients.

OBJECTIVE: Hepatitis C virus (HCV) infection exerts diverse effects on atherogenesis. We investigated whether malnutrition inflammation score (MIS) is associated with the presence of coronary artery disease (CAD) in anti-HCV-positive hemodialysis (HD) patients. SUBJECTS/METHODS: Twenty-two anti-HCV-positive HD patients with CAD and 61 anti-HCV-positive HD patients without CAD (as controls) were included. Data were obtained from hospital records, patients were evaluated for risk factors for CAD. The same physician performed MIS evaluation. RESULTS: MIS of anti-HCV-positive HD patients with CAD were significantly higher than patients without CAD (8.8+/-4.0 vs 6.5+/-2.6, P=0.02). In patients with CAD, basal (P=0.002) and peak C-reactive protein (P=0.03) and serum ferritin (P=0.01) concentrations were higher, serum albumin concentrations (P=0.003) were lower than those patients without CAD. MIS was positively correlated with age (r=+0.359, P=0.001) and viral load (r=+0.629, P<0.0001). In univariate logistic regression analysis, advanced age (odds ratios (OR)=1.093, confidence interval (CI): 1.039-1.150, P=0.001), hypertension (OR=3.143, CI: 1.084-9.116, P=0.035), diabetes mellitus (OR=5.344, CI: 1.343-21.269, P=0.017), low triglyceride (OR=0.992, CI: 0.984-0.999, P=0.026) and high MIS (OR=1.259, CI: 1.066-1.488, P=0.007) were associated with the presence of CAD. Multivariate logistic regression analysis identified age (OR=1.090, CI: 1.007-1.179, P=0.033) and MIS as the factors associated with the presence of CAD (OR=1.232, CI: 1.004-1.511, P=0.04). CONCLUSIONS: MIS may be associated with CAD in anti-HCV-positive HD patients.

Protective effect of resveratrol, a red wine constituent polyphenol, on rats subjected to portal vein thrombosis.

This experimental study investigated the prophylactic effects of the antioxidant and antiaggregant compound resveratrol (R) on portal vein thrombosis (PVT) in rats. Thirty rats weighing 200- 250 g were distributed in 3 groups: Group A (n = 10) and underwent PVT+R, Group B (n = 10) PVT alone, and Group C (n = 10) were subjected to a sham operation. Group A rats received R (60 mg/d per naso-gastric tube) for 10 days before PVT. Concerning antioxidant status, statistically significant increases in both tissue and plasma levels of reduced glutathione (GSH) and decrease in malondialdehyde (MDA) levels were observed in the PVT+R group compared with the PVT group (P < .001 for all). Comparison of these parameters with those of the sham group revealed significantly higher tissue and plasma levels of GSH and low MDA levels among the sham-operated group when compared with to the PVT+R or PVT groups (P < .001 for all). Concerning the antiaggregant status, significant increases of c-AMP levels were detected in rats treated with R before experiencing PVT (P < .001). Cyclic AMP levels in the sham group were significantly higher than those of either the PVT or PVT+R groups (P < .001). One may advise patients undergoing liver transplantation and carrying certain cardiovascular disease risk factors to ingest foods containing R to minimize PVT.

Effect of resveratrol on oxidative stress enzymes in rats subjected to 70% partial hepatectomy.

This experimental study investigated the antioxidant status of rats after resveratrol (R) treatment following 70% partial hepatectomy. Thirty Wistar albino rats (200 to 250 g) were divided among: groups A and B (n = 10 each) underwent laparotomy and 70% partial hepatectomy (PH). Whereas rats in group A received resveratrol 60 mg/d per nasogastric tube for 7 days before and 3 days after PH (PH + R), those in group B underwent PH only. Rats in group C (n = 10) were subjected to a sham operation. Significant increases in tissue levels of reduced glutathione (GSH) and decreased malondialdehyde (MDA) levels were observed in the PH group receiving R compared with those of the PH group (P < .001 for all). Comparison of these parameters with those of the sham group revealed significantly higher tissue levels of GSH and lower MDA levels among sham-operated compared with PH + R and PH groups (P < .001 for all). Concerning the NO levels, a trend to a slightly decrease was observed in the PH + R group (P < .06). Interleukin-6 levels showed significant decreases in both PH + R and PH groups (P < .001 and P < .05, respectively). The tissue GSH levels were slightly decreased in PH + R (P < .05), and decreased in the PH group compared with the controls (P = .002). We have suggested that patients undergoing living donor liver transplantation would likely benefit from prophylactic treatment with foods having resveratrol.

Management of recurrent thrombosis in liver transplant recipients: a case report.

Intra-abdominal thrombotic complications in orthotopic liver transplantation can cause devastating results. The management of these patients after thrombosis remains a difficult clinical problem. We present a case report of a patient who developed recurrent venous, thrombosis after liver transplantation performed because of cirrhosis due to autoimmune hepatitis. She had bleeding episodes during and early after the transplantation procedure and developed portal vein thrombosis after a single dose of recombinant factor VII, which was given for treatment of hemorrhage. She had her second thrombotic attack while she was on warfarin therapy which was initiated after the first bout. No hereditary or immunologic risk factors were found. Management of these patients can be difficult because of the liver's effect on the coagulation profile.

Endovascular stent placement in patients with hepatic artery stenoses or thromboses after liver transplant.

Hepatic artery stenosis or thrombosis following liver transplant is a potentially life-threatening complication. Successful liver transplant depends on uncompromised hepatic arterial inflow. Early diagnosis and treatment of complications prolong graft survival. Interventional radiologic techniques are frequently used to treat hepatic artery complications. Twenty patients with hepatic artery stenoses (n = 11) or thromboses (n = 9) were included in this study. Eighteen of the 20 patients were successfully treated by stent placement. In 9 patients, early endovascular interventions were performed 1 to 7 days after surgery. Two patients were operated owing to the effects of dissection and bleeding from the hepatic artery. Repeat endovascular interventions were performed 10 times in 6 patients. Follow-up ranged from 5 months to 4.5 years. Nine patients with patent hepatic arteries died during follow-up owing to reasons unrelated to the hepatic artery interventions. In 3 patients, the stents became occluded at 3, 5, and 9 months after surgery but no clinical symptoms were present.

A household study to determine attitudes and beliefs related to organ transplantation and donation: a pilot study in Yapracik Village, Ankara, Turkey.

Rural areas display adverse attitudes toward organ donation. Through a population-based cross-sectional study of people 18 years of age or older in the rural area of Ankara, Yapracik Village, Turkey, we identified the attitudes and beliefs of people related to organ transplantation and organ donation. The research universe included 87 people in 75 households. The research instrument was a questionnaire. None of the respondents had been involved in organ donation. The percentage of willingness to donate an organ was 47% which was significantly associated with younger age, including 34.4% who expressed willingness while alive. Twenty-five percent believed that their religion is adverse to transplantation, 28% thought it would create pain in death, 20% were afraid, and 83% believed in life afterwards, 15% said that their custom and usage were adverse to organ donation, 50% stated that they can accept organ donation from other races, and 65% stated that they can request organs from their friends. Eighty percent thought that organ donation is a gift given to a human; 34% of them stated that they can be a donor while they are alive. Fifty-four percent of respondents stated that they wanted to get information about organ donation and transplantation. Therefore basic educational campaigns targeting the increase of knowledge about organ donation are warranted in the rural population. There is a need to increase awareness about organ donation and transplantation. Findings like those in this study will help campaigns conducted for organ donation.

One center's experience with antithymocyte globulin treatment for acute rejection in renal transplantation.

Antithymocyte globulin (ATG) is a polyclonal antibody used in renal transplantation for prevention and treatment of acute rejection. In this study we have presented the outcomes of 23 cases treated with ATG due to steroid-resistant acute rejection episodes in 17 male and 6 female recipients. Sixteen transplantations were performed from cadaver donors and the other 7 from living-related donors. The mean recipient age was 31.9 +/- 9 years and the mean donor age was 56.3 +/- 10.8 years. ATG treatment was administered in doses of 3-5 mg/kg/d for 10 or 14 days. All patients received the same premedication before the ATG treatment; we did not encounter any ATG-related side effects. ATG doses were adjusted according to the T-lymphocyte levels. All recipients were followed up for infectious complications, for graft function, and for immunologic parameters of CD3 levels, CD4 levels, CD3/CD4 ratios, lymphocyte, and polymorphonuclear leukocyte numbers. According to the Banff criteria introduced in 1997, 4 patients displayed humoral rejection: 3 had type 3; 5 had type 2; and 11 had type 1 acute rejection episodes. Nine patients developed infectious complication during the follow-up. Three had pulmonary aspergillosis; 2 had cytomegalovirus infection; and 4 had bacterial infections. One patient who experienced aspergillosis died with a functioning graft, and the remaining 8 patients were treated successfully. Graft function improved in 19 (83%) cases. The other 4 patients returned to hemodialysis. Mean creatinine levels decreased from 4 +/- 1.7 to 2.1 +/- 0.2 mg/dL. We did not observe any relationship between the immunologic parameters and infectious complications. In conclusion, although ATG is a powerful drug to treat steroid-resistant acute rejection episodes, there was no precise way to monitor the intensity of immunosuppression to prevent infectious complications.

Impact of hepatitis serology on development of leukopenia after solid organ transplantation.

BACKGROUND: Homologous organ transplantation is an accepted therapeutic modality for end-stage disease of the kidney and liver. In posttransplantation periods leukopenia is a common problem with a wide range of differential diagnoses. Not only can it lead to an increased incidence of infections, but preclude the use of adequate immunosuppressive therapy and antimicrobial regimens because of their potential leukopenic side effects. One reason for leukopenia is viral hepatitis, which is frequently seen in transplant recipients. Herein this report, we searched for the relationship of leukopenic bouts among kidney and liver transplantation recipients to hepatitis serology. METHODS: We retrospectively evaluated the records of 569 patients who received solid transplants between January 1996 and October 2006. Because 27 patients did not come for follow-up examinations, their data were excluded, and 14 patients had 2 transplantations, yielding 556 primary transplantation cases for leukopenic attacks. RESULTS: Leukopenic attacks showed a strong relationship with hepatitis B virus (HBV) infection, but were independent of HBV DNA status (P = .002). No relationship with hepatitis C virus (HCV) infection status was found. CONCLUSIONS: Leukopenia is a common, important complication that can be seen during the posttransplantation period of recipients affecting both mortality and morbidity. HBV infection is a risk factor for development of leukopenia after transplantation. Adequate treatment of HBV infection in transplant recipients is important to obtain leukocyte counts in the normal range, allowing easier and safe antibacterial and immunosuppressive therapy in the posttransplantation period.

Usefulness of hepatobiliary scintigraphy for the evaluation of living related liver transplant recipients in the early postoperative period.

AIM: The aim of this study was to investigate the usefulness of hepatobiliary scintigraphy for the evaluation of liver grafts in the early postoperative period in patients receiving liver transplants from living related donors. MATERIALS AND METHODS: Fifty-six liver transplant recipients who received grafts from living related donors were included in the study. We examined the hepatobiliary scintigraphies of all patients, which were performed 7 to 10 days after the transplantation. The scintigraphic images were evaluated visually in terms of hepatic parenchymal function and biliary and vascular complications. RESULTS: In 44/56 recipients, hepatobiliary scintigraphy was completely normal in the early postoperative period. However, in 6/56 cases, scintigraphy was interpreted to show parenchymal dysfunction. In these patients, histopathologic confirmation by biopsies revealed four cases of hepatocellular damage/cholestasis, one acute rejection, and one cholangitis. In 3/56 patients, hepatobiliary scintigraphy demonstrated a hypoactive area in the liver graft; however, the other areas showed normal function. When the abdominal computed tomography (CT) and CT angiography were evaluated, these hypoactive areas were discovered to be related to minor vascular problems. In 3/56 liver graft recipients whose grafts showed normal parenchymal function scintigraphically, images were interpreted to indicate bile leak because accumulation of tracer was seen at an abnormal physiological site. CONCLUSION: Hepatobiliary scintigraphy, which is a noninvasive and objective method, is useful to assess grafts in the early postoperative period among patients who received liver transplants from living related donors.

Postsurgical complications in living-related liver donors.

From September 2001 until March 2007, we performed 127 living-donor liver transplantations in our transplantation center. Of 127 donors, 74 were men and 53 women, of overall mean donor age of 35.2 +/- 9.3 years (range, 20-56 years). Ninety-six (75.6%) were first-degree relatives, 18 (14.1%) were second-degree relatives, and 13 (10.3%) were spouses. We performed 34 (26.7%) left hepatic lobectomies, 33 (25.3%) left lateral segmentectomies, and 60 (48%) right hepatic lobectomies. The mean percentages of remnant to donor total liver volume for the right, left, and left-lateral lobectomies were 41.7%, 67.8%, and 75.1%, respectively. The mean length of patient postoperative hospital stay was 7.4 +/- 3.1 days (range, 3-33 days). There was no postoperative mortality. Ten complications occurred in 7 of the 127 donors (5.5%). Most complications were treated with radiologic interventions. In conclusion, donor safety should be the primary focus in living-donor liver transplantation. More experience, improved surgical techniques, and meticulous donor evaluation will help to minimize morbidity and mortality for living liver donors.