Gastroenterology
Volume 142, Issue 2 , Pages 273-280, February 2012

Estimates of Early Death, Acute Liver Failure, and Long-term Mortality Among Live Liver Donors

  • Abimereki D. Muzaale

      Affiliations

    • Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
    • Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland
    • ,
  • Nabil N. Dagher

      Affiliations

    • Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
    • ,
  • Robert A. Montgomery

      Affiliations

    • Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
    • ,
  • Sarah E. Taranto

      Affiliations

    • United Network for Organ Sharing, Richmond, Virginia
    • ,
  • Maureen A. Mcbride

      Affiliations

    • United Network for Organ Sharing, Richmond, Virginia
    • ,
  • Dorry L. Segev

      Affiliations

    • Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
    • Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland
    • Corresponding Author InformationReprint requests Address requests for reprints to: Dorry L. Segev, MD, PhD, Johns Hopkins Medical Institutions, 720 Rutland Avenue, Ross 771B, Baltimore, Maryland 21205. (410) 614-2079

Received 27 June 2011; accepted 2 November 2011. published online 21 November 2011.

Background & Aims

We sought to estimate the risk of perioperative mortality or acute liver failure for live liver donors in the United States and avoid selection or ascertainment biases and sample size limitations.

Methods

We followed up 4111 live liver donors in the United States between April 1994 and March 2011 for a mean of 7.6 years; deaths were determined from the Social Security Death Master File. Survival data were compared with those from live kidney donors and healthy participants of the National Health and Nutrition Examination Survey (NHANES) III.

Results

Seven donors had early deaths (1.7 per 1000; 95% confidence interval [CI], 0.7–3.5); risk of death did not vary with age of the liver recipient (1.7 per 1000 for adults vs 1.6 per 1000 for pediatric recipients; P = .9) or portion of liver donated (2.0 per 1000 for left lateral segment, 2.8 per 1000 for left lobe, and 1.5 per 1000 for right lobe; P = .8). There were 11 catastrophic events (early deaths or acute liver failures; 2.9 per 1000; 95% CI, 1.5–5.1); similarly, risk did not vary with recipient age (3.1 per 1000 adult vs 1.6 per 1000 pediatric; P = .4) or portion of liver donated (2.0 per 1000 for left lateral segment, 2.8 per 1000 for left lobe, and 3.3 per 1000 for right lobe; P = .9). Long-term mortality of live liver donors was comparable to that of live kidney donors and NHANES participants (1.2%, 1.2%, and 1.4% at 11 years, respectively; P = .9).

Conclusions

The risk of early death among live liver donors in the United States is 1.7 per 1000 donors. Mortality of live liver donors does not differ from that of healthy, matched individuals over a mean of 7.6 years.

Keywords:  Liver Donation , Risk of Death , Complication , LDLT

Abbreviations used in this paper:  BMI, body mass index, CI, confidence interval, DDLT, deceased donor liver transplantation, LDLT, live donor liver transplantation, NHANES, National Health and Nutrition Examination Survey, OPTN, Organ Procurement and Transplantation Network, SSDMF, Social Security Death Master File

 

 Conflicts of interest The authors disclose no conflicts.

 Funding The Organ Procurement and Transplantation Network is supported by Health Resources and Services Administration contract 234-2005-370011C. To ensure confidentiality of Social Security number data provided by the Organ Procurement and Transplantation Network, the Social Security number linkages to the Social Security Death Master File were performed solely by United Network for Organ Sharing staff (including Dr McBride and Ms Taranto).

PII: S0016-5085(11)01576-9

doi:10.1053/j.gastro.2011.11.015

Gastroenterology
Volume 142, Issue 2 , Pages 273-280, February 2012

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