Diaphragmatic Hernia After Living-Donor Right Hepatectomy: An Important Late Donor Complication.

Objective: This study was performed to evaluate the incidence and clinical outcome of diaphragmatic hernia after living-donor right hepatectomy.

Methods: Three hundred thirty-six patients (202 men, 134 women; mean age, 37.6 years) who underwent abdominal computed tomography (CT) after right donor hepatectomy were enrolled in this study. The CT images and the electronic medical records were reviewed. We evaluated the associations between diaphragmatic hernia and patient characteristics.

Results: Diaphragmatic hernia developed in 9 (2.7%) of 336 patients at a median time interval of 173 days (range, 98-488 days) after hepatectomy. In all 6 patients with available follow-up CT images, diaphragmatic hernia increased in size. Three patients presented with abdominal pain and underwent diaphragmatic repair. Diaphragmatic hernia was associated with older age but not with body mass index or sex.

Conclusions: Clinicians and radiologists should not overlook the possibility of diaphragmatic hernia after living-donor right hepatectomy, especially in old liver donors.