Risk Threshold for Living Donor Death in Liver Transplantation

Should living donor death be a “zero event” in liver transplantation surgery?

Image via Flickr user beth821 by Creative Commons License

This was one of the questions posed by Dr. Michael M. Abecassis, chief of the division of organ transplantation at Chicago’s Northwestern Memorial Hospital, during his Thomas E. Starzl Transplant Surgery State-of-the-Art lecture in Boston over the weekend at the annual meeting of the American Association for the Study of Liver Diseases.

“If we truly believe that living donor death should be a zero event, we should not be doing living donor transplants, because it will never be a zero event,” Dr. Abecassis said. Zero events are defined as things “that should never, ever happen, such as operating on the wrong side of a patient,” he said. “In living donor transplantation there are factors much beyond our control that can result in a donor death.” Two recent living donor deaths—one death occurred in late May at the Lahey Clinic in Burlington, Mass., and the other occurred in early August at the University of Colorado Hospital in Aurora—are a testament to this statement.

“Clearly, we just have to accept that donor death will never be a zero event, whether it’s kidney donor or liver donor, and we have to make a decision about what is the right risk threshold,” Dr. Abecassis stated.

In your opinion, what is an acceptable risk threshold?

–Diana Mahoney (on twitter @DMPM1)

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3 Comments

Filed under Health Policy, Hospital and Critical Care Medicine, IMNG, Practice Trends, Surgery, Transplant Medicine and Surgery, Uncategorized

3 responses to “Risk Threshold for Living Donor Death in Liver Transplantation

  1. My opinion is that Dr. Abecassis and every other transplant surgeon, physician and pro-living donation cheerleader should have to donate a kidney and/or chunk of their liver before uttering a word about ‘acceptable risk thresholds’.

    Lead by example and all that…

  2. donation

    my opnion is that living donation could be avoided if donation after death was more frequent

  3. srini

    Wonder if doctors are in a hurry to capitalize on money, and fame to achieve transplant success, thereby overlooking safety aspects with regards to donor and the surgery & hence the fatal donor casualties!

    Am quoting from a prominent liver journal which says

    ” Secrecy is unacceptable, as it leads to gossip and speculation by others. It belittles and negates the efforts of the wider transplant community to place living donor liver transplantation on a sound scientific footing. Without self-disclosure by transplant centers or registries on donor morbidity and mortality, it is difficult to envisage that the profession will remain free from public scrutiny and indeed condemnation of what could be perceived as a dark chapter in the history of liver transplantation.(168)”

    The teams that involved in these fatal surgeries be held to document the whole process, from counselling to operation theatre and document, where and how it went wrong, under supervision of a expert committee judge or law-maker!

    am enclosing a link to another botched Liver Transplant surgery, which was recorded by BBC, UK but never shown to the world.

    http://nigelheatonfiles.blogspot.in/

    Whither BBC media ethics?

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