Right hepatectomy for living donation: Role of remnant liver volume in predicting hepatic dysfunction and complications

Background Extensive attention has been placed on remnant liver volume (RLV) above other factors to ensure donor safety. Methods We performed a retrospective review of 137 right hepatectomies in live donors between June 1999 and November 2010. Results Median right lobe volume was 1,029 cm 3 , which correlated with its actual weight (r = 0.63, P 3 . Of the donors, 32 (24%) developed postoperative hepatic dysfunction (bilirubin >3 mg/dL or prothrombin time >18 s on postoperative day 4). RLV did not predict postoperative hepatic dysfunction ( P = .9), but it was associated with peak international normalized ratio (INR) ( P = .04). Donor age and male gender were predictors of increased bilirubin at postoperative day 4 (age, P = .03; gender, P = .02). Of the donors, 45 (33%) experienced complications, and 24 donors had RLVs P = .3). Cell-saver utilization and aspartate-aminotransferase (AST) levels (OR = 3) were associated with complications. Volumetric assessment can predict RLV accurately. Conclusion Although no demonstrable association between RLV