A Rare Case Report: Hemodynamic Responses and Exercise Capacity Before and After Becoming a Non-Biological Live Liver Donor

Background: According to the United States Department of Health and Human services 8,497 liver transplants were accomplished in the United States in 2016. Of those transplants, only 345 (4.1%) of the transplants came from a live donor and only 9 (0.03%) of the live donor transplants came from a nonbiological paired donor [1]. Very little published data exists regarding Living Donor Liver Transplant (LDLT) influences on the live donor’s responses to exercise post-surgery. Purpose: To study the acute and prolonged effects of exercise and LDLT on heart rate, blood pressure, Lactate, Glucose, estimated maximal aerobic capacity, muscular strength, and the responses during submaximal exercise testing (6MWT and/or submaximal Bruce protocol). Methods: A single female subject, age 53 years, volunteered to participate in this study after already agreeing to become a live liver donor. Data was obtained once prior to the procedure and every month thereafter, for a total of eight months post-surgery. Conclusions: There was minimal changes in aerobic capacity and strength due to lack of consistency with an exercise program. Findings of this case report cannot be generalized to all LDLT donors. However, the information on the recovery of an LDLT donor in respect to exercise testing may be beneficial to clinicians and professionals in prescribing an exercise program for similar patients in similar circumstances.

Laparoscopy-Assisted versus Open Hepatectomy for Live Liver Donor: Systematic Review and Meta-Analysis

Objective. To assess the feasibility, safety, and potential benefits of laparoscopy-assisted living donor hepatectomy (LADH) in comparison with open living donor hepatectomy (ODH) for liver transplantation. Background. LADH is becoming increasingly common for living donor liver transplant around the world. We aim to determine the efficacy of LADH and compare it with ODH. Methods. A systematic search on PubMed, Embase, Cochrane Library, and Web of Science was conducted in May 2017. Results. Nine studies were suitable for this analysis, involving 979 patients. LADH seemed to be associated with increased operation time (WMD = 24.85 min; 95% CI: −3.01~52.78, P=0.08), less intraoperative blood loss (WMD = −59.92 ml; 95% CI: −94.58~−25.27, P=0.0007), similar hospital stays (WMD = −0.47 d; 95% CI: −1.78~0.83, P=0.47), less postoperative complications (RR = 0.70, 95% CI: 0.51~0.94, P=0.02), less analgesic use (SMD = −0.22; 95% CI: −0.44~−0.11, P=0.04), similar transfusion rates (RR = 0.82; 95% CI: 0.24~3.12, P=0.82), and similar graft weights (WMD = 7.31 g; 95% CI: −23.45~38.07, P=0.64). Conclusion. Our results indicate that LADH is a safe and effective technique and, when compared to ODH.