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Turkish Journal of Medical Sciences

Author ORCID Identifier

BORA BARUT: 0000-0001-9489-5973

CENGİZ CEYLAN: 0000-0003-3471-8726

AKİLE ZENGİN: 0000-0003-09818901

MEHMET GÜZEL: 0000-0001-6959-8539

YASİN DALDA: 0000-0002-0701-8399

SEZAİ YILMAZ: 0000-0002-8044-0297

DOI

10.55730/1300-0144.5863

Abstract

AbstractBackground/aim: Despite advancements in surgical methodologies and the extensive perioperative and postoperative care administered to recipients, the prevalence of complications requiring early re-laparotomy following living donor liver transplantation remains persistent. This investigation seeks to analyze the determinants influencing re-laparotomy occurrences in the initial 30 days following living donor liver transplantation. Additionally, our goal is to evaluate the impact of early laparotomy on both graft and patient survival within this distinct patient cohort.Materials and methods: The study encompassed recipients (n=535) aged 18 years and older who underwent primary living donor liver transplantation at our institution from January 2019 to December 2021. Exclusion criteria involved patients necessitating early re-transplantation. Early re-laparotomy was specified as surgical intervention within the initial 30 days following living donor liver transplantation.Results: The study enrolled a total of 535 patients, among whom 85 (15.9%) underwent early re-laparotomy. The median age of the patients was 54 years (41-60), with a predominant male representation (66.2%). Univariate analysis comparing laparotomy and non-re-laparotomy groups revealed statistically significant differences in creatinine (p=0.043), sodium (p=0.025), graft side (p<0.001), etiology (p=0.005), and blood loss (p=0.012).In the multivariate analysis, creatinine (p=0.039; OR=1.668; 95% CI=1.027-2.709) and left lobe graft (p<0.0001; OR=3.611; 95% CI=1.960-6.652) emerged as independent risk factors for re-laparotomy.Conclusion: The primary causes of early re-laparotomy following living donor liver transplantation include postoperative bleeding, biliary leakage, and vascular complications. Preoperative elevation in creatinine and sodium levels, the presence of Budd-Chiari syndrome, utilization of a left lobe graft, and intraoperative blood loss are identified as risk factors associated with early re-laparotomy after Living Donor Liver Transplantation (LDLT). Patients undergoing early re-laparotomy exhibit inferior survival rates compared to those who do not undergo such interventions.

Keywords

Early, re-laparotomy, recipients, living donor, liver transplantation

First Page

881

Last Page

886

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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