Frequency and Risk factors of Reoperation in LDLT Donors

Background: Liver transplantation (LT) is the definitive treatment for end-stage liver disease, acute liver failure, liver tumors, and metabolic diseases. Re-exploration after surgery is associated with poor clinical outcomes and is considered a quality-of-care measure. Objective: To determ...

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Main Authors: Hamid Raza Laghari, Aamir Bashir, Muhammad Akram, Ibrahim Asghar, Usman Ali Rizvi, Sirajuddin, Umar Baloch
Format: Article
Language:English
Published: Frontier Science Associates 2024-09-01
Series:The International Journal of Frontier Sciences
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Online Access:https://p2024.frontierscienceassociates.com.pk/index.php/tijfs/article/view/195
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Summary:Background: Liver transplantation (LT) is the definitive treatment for end-stage liver disease, acute liver failure, liver tumors, and metabolic diseases. Re-exploration after surgery is associated with poor clinical outcomes and is considered a quality-of-care measure. Objective: To determine the frequency and risk factors of reoperation (early re-laparotomy) after hepatectomy in postoperative LDLT donors. Materials and Methods: A cross-sectional analytical study was conducted at the Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences between December 2023 and May 2024. This study included 672 LDLT donors aged > 18 years old. Data on donor age, sex, blood group, operation time, and re-exploration were collected. The primary endpoints were the frequency and causes of re-exploration, and the secondary endpoints included the association of re-exploration with clinical outcomes. Statistical analyses were performed using SPSS 25.0, with the significance level set at P < 0.05. Blood group analysis revealed that 57.9% of reexplored donors had blood group B+. Results: The frequency of re-exploration was 2.8%. Among those requiring re-exploration, 42.1% were aged 21-28 years. The difference in re-exploration rates between male and female patients was statistically significant (P<0.001). Blood group analysis revealed that 57.9% of the reexplored donors had blood group B+. Bleeding was the primary cause of re-exploration in 73.7% of cases. The majority (57.9%) of re-explorations occurred in patients with operation times between 451-550 minutes. However, the significant sex disparity and high incidence of bleeding as a cause for re-exploration underscores the need for improved postoperative care. Conclusion: This study highlights a relatively low frequency of re-exploration (2.8%) among LDLT donors. However, the significant sex disparity and high incidence of bleeding as a cause for re-exploration underscore the need for improved postoperative care.
ISSN:2618-0359
2618-0367