Outcomes of living liver donors are worse than those of matched healthy controls
- Authors
- Choi, Jin Yong; Kim, Jae Heon; Kim, Jong Man; Kim, Hyun Jung; Ahn, Hyeong Sik; Joh, Jae-Won
- Issue Date
- Mar-2022
- Publisher
- Elsevier BV
- Keywords
- living liver donors; liver transplantation; mortality; outcomes
- Citation
- Journal of Hepatology, v.76, no.3, pp 628 - 638
- Pages
- 11
- Indexed
- SCIE
SCOPUS
- Journal Title
- Journal of Hepatology
- Volume
- 76
- Number
- 3
- Start Page
- 628
- End Page
- 638
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/55488
- DOI
- 10.1016/j.jhep.2021.10.031
- ISSN
- 0168-8278
1600-0641
- Abstract
- Background & Aims
Donor death is the most serious complication of living liver donation but is reported rarely. We investigated the actual mortality of living liver donors (LLDs) compared with matched control groups based on analysis of the Korean National Health Insurance Services (NHIS) database.
Methods
This cohort study included 12,372 LLDs who donated a liver graft between 2002 and 2018, and were registered in the Korean Network for Organ Sharing. They were compared to 3 matched control groups selected from the Korean NHIS and comprising a total of 123,710 individuals: healthy population (Group I); general population without comorbidities (Group II); and general population with comorbidities (Group III).
Results
In this population, 78.5% of living liver donors were 20-39 years old, and 64.7% of all donors were male. Eighty-nine donors (0.7%) in the LLD group died (68 males and 21 females), a mortality rate (/1,000 person-years) of 0.91 (0.74-1.12). Mortality rate ratio and the adjusted hazard ratio of the LLD group was 2.03 (1.61-2.55) and 1.71 (1.31-2.25) compared to Control Group I, 0.75 (0.60-0.93) and 0.63 (0.49-0.82) compared to Control Group II, and 0.58 (0.46-0.71) and 0.49 (0.39-0.60) compared to Control Group III. LLD group, depression, and lower income were risk factors for adjusted mortality. The incidence of liver failure, depression, cancer, diabetes, hypertension, brain infarction, brain hemorrhage, and end-stage renal disease in the LLD group was significantly higher than in Control Group I.
Conclusions
Outcomes of the LLD group were worse than those of the matched healthy control group despite the small number of deaths and medical morbidities in this group. LLDs should receive careful medical attention for an extended period after donation.
Lay summary
The incidence of mortality, liver failure, depression, cancer, diabetes, hypertension, brain infarction, brain hemorrhage, and end-stage renal disease in the living liver donor group was significantly higher than in the matched healthy group. Careful donor evaluation and selection processes can improve donor safety and enable safe living donor liver transplantation.
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Collections - 1. Basic Science > Department of Preventive Medicine > 1. Journal Articles
- 3. Graduate School > Graduate School > 1. Journal Articles
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