XXXX after live related donor hepatectomy: Incidence, predictors and implications for safety of thoracic epidural catheter.

@entity190 @entity86 @entity1003
BACKGROUND: @entity1003 after living donor hepatectomy (LDH) may endanger donor safety during removal of thoracic epidural catheter (TEC). The present study was conducted to evaluate the extent and duration of immediate @entity86 after LDH. MATERIALS AND METHODS: A retrospective analysis of perioperative record of LDH over three years was conducted after IRB approval. Variables such as age, gender, BMI, ASA classification, liver volume on CT scan, preoperative and postoperative INR, platelet count (PC) and ALT of each donor for five days was noted. In addition, duration of surgery, remnant as percentage total liver volume (Remnant%), @entity190 , day of peak in PC and INR were also noted. @entity1003 was defined as being present if INR exceeded 1.5 or platelet count fell below 1 * 10 5 /mm 3 on any day. Data was analyzed using SPSS 20 for Windows. Between group comparison was made using the Student 't' test for continuous variables and chi square test for categorical variables. Univariate analysis was done. Multiple logistic regression analysis was used to find independent factor associated with @entity1003 . RESULTS: Eighty four (84) donors had @entity1003 on second day (mean INR 1.9    0.42). Low BMI, % of remnant liver and duration of surgery were independent predictors of @entity1003 . Right lobe hepatectomy had more @entity1003 than left lobe and low BMI was the only independent predictor. There was no correlation of @entity1003 with age, gender, @entity190 , presence of epidural catheter, postoperative ALT or duration of hospital stay. High INR was the main contributor for @entity1003 . CONCLUSIONS: @entity1003 is seen after donor hepatectomy. We recommend removal of the epidural catheter after the fifth postoperative day when INR falls below 1.5.
