Health-related Quality of Life of Liver Donors: A Prospective Longitudinal Study.

Living donor liver transplantation is a widely accepted option to treat liver diseases in several indications. Risk of liver donation is being discussed and quality of life of donors is also studied. Changes and the change pattern of quality of life were analyzed in this prospective longitudinal study. PATIENTS AND METHODS: Fifty-five donors were included. The Medical Outcomes Study Short Form 36 (SF-36) was fulfilled either in-person or during a telephone interview each donor preoperatively and at the end of the third, sixth, and 12th months. RESULTS: Physical subdomain scores of SF-36 decreased significantly in the third postoperative month compared to preoperative score. The scores recovered in the sixth postoperative month, except for the bodily pain domain. The pain score recovered at the end of the 12th month. While social functioning score among mental subdomains of SF-36 temporarily decreased and recovered at postoperative 12th month, other mental subdomain scores and mental composition summary scores did not show a significant change. CONCLUSION: The quality of life of living liver donors is not permanently affected by donation. There are well-defined changes in the physical aspects of the quality of life that all seem to recover within 1 year. Donors should be preoperatively informed about this temporary change as well as complications.

The effects of exercise on portal venous system in splenectomized adults.

OBJECTIVES: This study was designed to assess the effects of exercise on the portal venous system in splenectomized adults. BACKGROUND: Splenectomy is a surgical intervention commonly performed at surgery clinics and recognized as a cause of portal vein thrombosis. Intensive exercise increases blood flow to the contracting muscles, causes hypercoagulability and vasoconstriction in the splanchnic area, hence the portal vein diameter, blood flow velocity and discharge decrease. METHODS: Forty adults participated in this investigation. Subjects were trained to run for twenty minutes on a treadmill at a velocity of 6 km/h and ten-degree elevation. We compared the white blood cell count, portal vein diameter, portal venous blood flow velocity and discharge of splenectomized and healthy adults before and after exercise. RESULTS: After exercise, the blood leukocyte count was significantly increased and the portal vein diameter was significantly reduced in both groups (p<0.001) but there were no statistically significant differences between the two groups. The portal venous blood flow rate in splenectomy group were significantly lower than in the control group (p<0.001). Furthermore the portal venous blood flow rates in both groups were significantly reduced after exercise (p<0.001). CONCLUSION: Exercise in splenectomized individuals can cause serious problems in form of decreasing splanchnic flow and increasing blood viscosity. After splenectomy, both healthy individuals and patients with hematologic diseases ought to avoid intensive exercises (Tab. 2, Ref. 16).

Partial cholecystectomy is a safe and efficient method.

AIM: When there is excess inflammation, fibrosis and portal hypertension around gall bladder or in presence of Mirizzi syndrome, bile ducts and hepatic artery may be possibly damaged during dissection of Calot triangle. In this study, we examined safety and efficiency of partial cholecystectomy operation which we perform when dissection of Calot triangle is challenging. METHOD AND MATERIAL: Eighteen patients who were undergone partial cholecystectomy in our clinic between 1996 and 2008 were retrospectively evaluated. Mean age of patients was 66 years (range: 55-88 years) and ratio of male/female was 2/1 (12 men, 6 women). Fourteen patients were undergone general anesthesia, whereas 4 patients were operated under epidural anesthesia. Partial cholecystectomies were performed by right subcostal incision in 16 patients and by right paramedian incision in 2 patients. RESULTS: No intra-operative or early post-operative mortality was found among patients. Post-operative subhepatic abscess occurred in one patient (5.5%) and superficial wound site infection occurred in 4 patients (22,2%). Controlled bile fistula occurred in early post-operative period in two patients (11.1%) and fistula spontaneously closed without requiring additional surgical procedure. Escherichia coli were most common microorganism found in bile culture. Mean hospitalization period of patients was 8 days (range: 15-14 days) and mean follow-up period was 80 months (8-150 months). During follow up, hepatobiliary ultrasonography could be re-performed in 8 patients and no new stone formation was observed. In 7 patients, it was understood verbally that no postoperative gastrointestinal symptoms were present. CONCLUSION: Where dissection of Calot triangle is changeling, partial cholecystectomy can be safely and efficiently performed.