Factor Predicting Cholestasis in Post Modified Right Lobe Hepatectomy in the Era of Standardized Donor Selection Protocols

Inspite of increase in number of living related liver transplantation (LRLT), right lobe donation continues to be high risk surgery. Of all the donor mortality reported so far post-operative liver failure secondary to small remnant remains high. Hence, we analysed our data to look for risk factors for cholestasis following post modified right lobe (MRL) donor hepatectomy.386 donors who underwent MRL donor hepatectomy from Feb 2017 to July 2019 were included in the study. We analysed data based on 2 cut off values of total bilirubin (Tbil), one based on median peak bilirubin (2.3 mg/dL) of study cohort and another 5 mg/dL which is considered as average high cut off of Tbil at our centre. With 2.3 mg/dL cut off, males, spouses, remnant %, graft weight, INR were significant (P<0.05). On analysis with Tbil 5 mg/dL cut off, male gender, blood group O, Body mass index (BMI), INR were significant (P<0.05).On multivariate analysis male donors alone tend to be high risk for cholestasis in both group and Blood group O in the Tbil >5 cut off group. Male gender and blood group O were significant risk factor for post MRL donor hepatectomy cholestasis.