The early results of 363 donor operations in Central Oil Worker's Hospital, Azerbaijan

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*Transplantation Center founded in 2009
*First Organ transplantation center in
Azerbaijan
*Routinely performing liver and kidney
transplantation operations
*So far 273 kidneys and 90 livers transplantation
were performed

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*Living donor liver transplantation (LDLT)
*No cadaveric liver transplantation program is
established yet

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* Outcome of our first 90 LDLTs at the Central
Oil Workers Hospital, Baku.
* Discuss the lessons learned
* Retrospective review between 2009 and 2016
for the following end point: donor
complications.

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*90 cases of adult-to-adult LDLT were
performed. The frequency of this operation has
increased over time, with 16 cases performed
over the past year.
* All donors were related to the recipient.

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*Donor age ranged from 19 to 54 years
*All donors presented on a strictly voluntary
basis
*Each donor underwent a thorough physical
examination and laboratory evaluation.

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*Imaging modalities of the donor not included
magnetic resonance angiography and
cholangiography
*Absolute liver volume was calculated based on
these scans

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*Liver biopsies were performed infrequently;
only 3 of the 90 eventual donors underwent a
biopsy

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*Marginal donor avoided in early stages of our
transplantation activity.
*Now we consider their candidateship possible

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*No. of donors 90 Sex (M/F) 64/26
* Mean age (yr) 32
*Mean Length of Stay (d) 7 +- 2

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*Right donor hepatectomy 82
*Left donor hepatectomy 4
*Left lateral segmentectomy 4

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* General anesthesia, with a thoracic epidural
catheter used for postoperative pain
management. A right subcostal incision with
upper midline extension similar to that
performed on the transplant recipient is used.
For left side hepatectomy and left lateral
segment resection upper midline incision is
adequate.

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* Using both clamp crush method and CUSA ,
parenchymal transection proceeds
*Intraoperative cholangiogram is obtained in all
cases

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*All 90 donors are alive, well, and have
returned to normal predonation activity.
*Of 90 donors, 3 required nonautologous blood
transfusions (2.7%). One of these was for
profuse bleeding secondary to IVC tear. The
second was in a patient whose hematocrit
decreased on postoperative day 2 and
stabilized after relaparotomy

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*One patient had postoperative bile leaks.
*The patient was treated conservatively with
percutaneous drainage, resulting in resolution
of the leak from the cut liver surface.
*Also, a temporary neuropraxia occurred in the
dominant hand of one donor.
*2 donor had prolonged hyperbilirubinaemia

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*Longer kidney survival
*Shorter wait time for transplant
*Surgery scheduled for convenience
*Healthy donor kidney
*Kidney works right away
*May be close genetic match
*Lower cost

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*Age 18 and older
*Good physical and mental health
*No chronic kidney stones
*No Diabetes
*No current and recent cancer
*Not a lot overweight
*High Blood pressure may be considered

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*Remove Healthy Kidney for Donation
*Ensure Safety of Donor Patient
*Ensure graft safety
*Minimize Scarring
*Minimize Recovery Time

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*In our center overall 273 renal transplantation were
performed between 2010-2016.
*2010-1
*2011-9
*2012-35
*2013-55
*2014-64
*2015-84
*2016-25

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*We retrospectively analyzed the data and
surgical complications for 273 patients who
underwent living donor nephrectomy between
2010 and 2016.
*Initial 116 operations were open nephrectomy.
*137 operations performed by hand assisted
laparoscopic approach
*25 nephrectomy by pure laparoscopic.

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*The donor mean age was 51.9 ± 7.6 years
(range 19 to 76),
*38% of the donors were men
*mean Body Mass Index was 26.4 ± 2.9 kg/m2.
*Mean operative time was 114.0 ± 35.0 minutes.
*Warm ischemic time was 2.5 ± 0.62 minutes.
*The donor’s mean hospital stay was 3.3 (range
2 to 7) and

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*Hand assisted and pure donor nephrectomies
were successfully completed in all patients.
*After a mean follow-up all donors are alive.
*There were no major donor complications.
*No conversion to open.

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*One patient presented a wound hematoma
responding to conservative treatment.
*And one case of lymphorrhea were registered.

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