Healthy Donors for Liver Transplantation
Conditions
Brief summary
Living donor liver transplantation (LDLT) is an important option for patients with end-stage liver disease requiring liver transplantation. When performing LDLT, the safety and well being of donors is of the utmost importance. The conventional incision for donor hepatectomy is a right subcostal incision with a midline extension up to xiphoid. Minimally invasive liver surgery throughout a single 10 cm upper midline incision without laparoscopic assistance has been widely applied and considered to be safe and effective. Recently, laparoscopic and minimally invasive living donor hepatectomy via transverse incision has been suggested to reduce morbidity and the invasiveness of living donor hepatectomy. Although minimally invasive approach has become the surgical method of choice for many transplant centers, little data on comparing the impact of all three different type incision in living liver donors. In our center, the investigators have adopted three different incision according to surgical teams. The investigators undertook this study with the aims of comparing the pain and quality of life of donors according to type of three different incisions and assessing any benefits to the donor due to the smaller midline incision during the early postoperative period.
Interventions
PROCEDUREhepatectomy conventional incision
This study was a single center, nonrandomized, observational comparative analysis of 3 different surgical technique. Three surgical teams operated alternately at our center, and donors undergoing hepatectomy via three different incision
PROCEDUREhepatectomy midline incision
PROCEDUREhepatectomy transverse incision
Sponsors
Samsung Medical Center
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* ASA (American Society of Anesthesiologists) physical status I-II, * adult undergoing hepatectomy for living donors
Exclusion criteria
* known allergy to any of the drugs used in this study, * bleeding diathesis, * neurologic dysfunction (preexisting lower limb neurological deficit), * recent systemic or local infections, * history of drug use, or * under treatment with opioids because of chronic pain
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| donor recovery/quality of life (as measure bye the quality of recovery [OoR] score) | postoperative 7 day | QoR (quality of recovery) -15, has recently been developed, which can provide an extensive yet efficient evaluation of postoperative recovery from the patient's perspective \[8\]. The QoR-15 is an abbreviation of the longer and more comprehensive QoR-40 \[15\], and includes questions on pain, physical comfort, physical independence, psychological support and emotional state, and can be completed in approximately 2 minutes. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| consumption of analgesics on postoperative day | 1, 4, 8, 24, 48 and 72 h after surgery | — |
| discomfort related to the scar | postoperative 7 day | abdominal wall sensorineural deficits (numbness and differences in tactile and temperature sensations) and tightness around the scar |
| side effects (nausea, vomiting, back pain, pruritus) | 1, 4, 8, 24, 48 and 72 h after surgery | nausea, vomiting, back pain, pruritus |
| donor recovery/quality of life (as measure bye the quality of recovery [OoR] score) | postoperative 30 day | QoR (quality of recovery) -15, has recently been developed, which can provide an extensive yet efficient evaluation of postoperative recovery from the patient's perspective \[8\]. The QoR-15 is an abbreviation of the longer and more comprehensive QoR-40 \[15\], and includes questions on pain, physical comfort, physical independence, psychological support and emotional state, and can be completed in approximately 2 minutes. |
| assessment of subjective pain (as measured by numeric rating scale [NRS]) on postoperative day | 1, 4, 8, 24, 48 and 72 h after surgery | numeric rating scale (NRS) in which; 0 = no pain and 100 = worst pain |
Countries
South Korea
Outcome results
None listed