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Textbook outcome among voluntary donors undergoing major living donor hepatectomy

Textbook outcome among voluntary donors undergoing major living donor hepatectomy PurposeTextbook outcome (TO) is a composite measure of outcome and provides superior assessment of quality of care after surgery. TO after major living donor hepatectomy (MLDH) has not been assessed. The objective of this study was to determine the rate of TO and its associated factors, after MLDH.MethodsThis was a single center retrospective review of living liver donors who underwent MLDH between 2012 and 2021 (n = 1022). The rate of TO and its associated factors was determined.ResultsAmong 1022 living donors (of whom 693 [67.8%] were males, median age 26 [range, 18–54] years), TO was achieved in 714 (69.9%) with no donor mortality. Majority of donors met the cutoffs for individual outcome measures: 908 (88.8%) for no major complications, 904 (88.5%) for ICU stay ≤ 2 days, 900 (88.1%) for hospital stay ≤ 10 days, 990 (96.9%) for no perioperative blood transfusion, 1004 (98.2%) for no 30-day re-admission, and 1014 (99.2%) for no post-hepatectomy liver failure. Early donation era (before streamlining of donor operative pathways) was associated with failure to achieve TO [OR 1.4, CI 1.1–1.9, P = 0.006]. TO was achieved in 506/755 (67%) donors in the early donation era versus 208/267 (77.9%) in the later period (P = 0.001).ConclusionDespite zero mortality and low complication rate, TO was achieved in approximately 70% donors. TO was modifiable and improved with changes in donor operative pathway. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Langenbeck s Archives of Surgery Springer Journals

Textbook outcome among voluntary donors undergoing major living donor hepatectomy

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References (33)

Publisher
Springer Journals
Copyright
Copyright © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022
ISSN
1435-2443
eISSN
1435-2451
DOI
10.1007/s00423-022-02578-6
Publisher site
See Article on Publisher Site

Abstract

PurposeTextbook outcome (TO) is a composite measure of outcome and provides superior assessment of quality of care after surgery. TO after major living donor hepatectomy (MLDH) has not been assessed. The objective of this study was to determine the rate of TO and its associated factors, after MLDH.MethodsThis was a single center retrospective review of living liver donors who underwent MLDH between 2012 and 2021 (n = 1022). The rate of TO and its associated factors was determined.ResultsAmong 1022 living donors (of whom 693 [67.8%] were males, median age 26 [range, 18–54] years), TO was achieved in 714 (69.9%) with no donor mortality. Majority of donors met the cutoffs for individual outcome measures: 908 (88.8%) for no major complications, 904 (88.5%) for ICU stay ≤ 2 days, 900 (88.1%) for hospital stay ≤ 10 days, 990 (96.9%) for no perioperative blood transfusion, 1004 (98.2%) for no 30-day re-admission, and 1014 (99.2%) for no post-hepatectomy liver failure. Early donation era (before streamlining of donor operative pathways) was associated with failure to achieve TO [OR 1.4, CI 1.1–1.9, P = 0.006]. TO was achieved in 506/755 (67%) donors in the early donation era versus 208/267 (77.9%) in the later period (P = 0.001).ConclusionDespite zero mortality and low complication rate, TO was achieved in approximately 70% donors. TO was modifiable and improved with changes in donor operative pathway.

Journal

Langenbeck s Archives of Surgery – Springer Journals

Published: Nov 1, 2022

Keywords: Right hepatectomy; Donor morbidity; Donor mortality; Post-hepatectomy liver failure; Future liver remnant

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