Sunday, February 14, 2010
Donor evaluation AND surgery risks.
Larry here just wanted to give some more fun information on living donation, the risks of the evaluation and actual surgery. I know most of it is redundant, but I found the statistics encouraging (in my opinion) tehehe.
**COMPLETE UNOS ARTICLE**
Risks of Living Liver Donor Evaluation
Some of the possible risks associated with the medical evaluation may include:
• Mild to severe allergic reaction due to exposure to contrast materials used in abdominal imaging.
• The discovery of infections or malignancies unknown to the potential donor.
• Complications from liver biopsy (if needed) range from 0.2% and 1.79%.(7)
• The discovery of diseases that must be reported to health agencies.
• HLA testing (if performed) could reveal the true identity of family relationships, and create issues that the
donor or other family members may not wish to be exposed. Test results may require unexpected
decisions of the donor and medical team.
• Test results may require the need for additional testing and treatments, which may become the financial responsibility of the donor or donor’s insurance.
The final decision regarding whether the living liver donor can donate an organ is based upon:
• The medical test results;
• The donor’s psychosocial evaluation;
• Assessment of risk based upon current medical knowledge;
• Willingness of the donor to proceed after receiving education about the entire donation process; and;
• Confirmation that the donor is an acceptable candidate based on the medical and psychological
((The really fine print))
Living liver donation involves risk. Most of the medical risks and complications associated with the partial hepatectomy procedure occur in the peri-operative period. These risks are relatively well known and can include:
• Risks associated with anesthesia;
• Surgical complications such as liver failure, blood loss, bile leak, blood clots, infection, pain, hernia; and less frequently bile duct stricture(2,3,4,5);
• Death - the risk of dying from living donor surgery is estimated to be between 0.1%-0.3% and possible as high as 0.5% when donating the right lobe(4)
• If all complications are considered, from the most minor to the most severe, approximately 1 of every 3 donors will experience a complication based upon multicenter consortium data. The great majority (95%) are considered minor or with no permanent sequelae. (22)
Recent OPTN data (6) reveal that: five out of 3632 (0.1%)living liver donors were subsequently listed for liver transplant between 4/1/1994 and 11/30/2008. One living donor died after being placed on waiting list, three candidates received deceased donor liver transplants within 4 days after listing, and one candidate was removed from the waiting list due to improved health.