A retrospective evaluation of causes of exempting living liver donors in an Egyptian centre.

Background And Study Aims: Living-related liver transplantation has helped to solve the problem of shortage of deceased organ donors. However, studies showed significant donor complications occurring with adult living liver donation. This study aims at assessing different causes of exclusion of potent living donor transplantation in Egypt.

Patients And Methods: The data of 158 living donors (corresponding to 50 consecutive transplanted cases) were retrospectively studied.

Results: Only 50 donors were found to meet all the preoperative assessment criteria while 108 potential donors were excluded at various assessment steps. Majority of the excluded potential donors were due to anatomical variations (52/108) followed by hepatic steatosis (19/108) and positive hepatitis B or C virus serology (11/108). Regarding the anatomic variations, biliary anomalies were ranked as the first cause to exclude donors with the majority of them having the type C biliary variant. Portal vein variations were the second most common cause of exclusion due to portal vein trifurcation. Hepatic artery variations were detected in a lesser number of excluded donors. No donors were excluded for hepatic vein anomalies.

Conclusion: Anatomical variations are the most common causes to exempt living liver donors. Preoperative evaluation of anatomical variations, viral serology and hepatic steatosis plays the major role to accept or exclude the potential donors.