Factors affecting Postoperative Hyperbilirubinemia in the Donor after Living Donor Liver Transplantation

Background/Aims: In living donor liver transplantation, hyperbilirubinemia is a common complication after donor hepatectomy, although donor liver function is principally normal. In this study, we therefore retrospectively analyzed factors affecting postoperative hyperbilirubinemia in the donor. Methodology: Between January 2005 and June 2007, 134 consecutive donors underwent donor hepatectomy for adult recipients at our center. Various parameters affecting postoperative hyperbilirubinemia related to donor and to the procedure, including preoperative total bilirubin (T-Bil) level, ratio of preoperatively estimated remnant liver volume and surgical duration were examined. Results: The mean postoperative maximum T-Bil level was 3.8mg/dL, ranging from 1.2 to 11.9mg/dL. Dividing patients into two groups by postoperative maximum T-Bil level, high T-Bil group (5mg/dL or more) had a significantly higher preoperative T-Bil level and lower ratio of remnant liver volume than the low T-Bil group (less than 2mg/dL) (P=0.007 and P<0.001, respectively). Moreover, similar analysis only in patients with right liver or extended right liver graft showed that preoperative higher T-Bil level and younger age were significantly associated with postoperative hyperbilirubinemia (P=0.009 and P=0.010, respectively). Conclusions: Postoperative hyperbilirubinemia in donor was closely related to preoperative T-Bil level, ratio of remnant liver volume, and donor age.