Background: Every year, more than 800 healthy people undergo hepatic resection for living liver donation in Korea. Although 27 years has passed since the first living donor liver transplantation has been reported, the long-term outcome of living liver donor still remains in question. The aim of this study is to determine the long-term outcome of living donor using national data base.
Methods: Live donors were drawn from a national registry of 10,116 live liver donors in Korea between February 9, 2000, and December 31, 2015. Population we selected for potential controls was Korean National Health Insurance System – National Sample Cohort (NHIS-NSC, 2002-2013) which is a nationally representative random sample of 1,025,340 individuals, account for 2.2% of the entire population in 2002. Excluding those with contraindications to be organ donors, 7,538 donors were 1:3 individually matched using sex and 5-year age group.
Results: The donor mortality rate was 0.2% (53/10,116) with 15-year survival rate 98.8%. There were 2 deaths within 60 days of live liver donation during the study period. There were 44 deaths in liver donors (n=7,538) and 40 deaths in controls (n=22,614) during the study period. The most common cause of death was suicide in both donors and controls which consists about 35% (n=30) in total deaths. Overall risk of death was higher in liver donors than controls (HR 3.30, 95% CI, 2.15 – 5.06). When analyzed according to the causes of death, risk of death from suicide (HR 3.43, 95% CI, 1.67 – 7.03), cancer (HR 21.00, 95% CI, 2.59 – 170.69) and unknown or unclassified reason (HR 3.43, 95% CI, 1.24 – 9.46) were significantly higher in liver donors than controls.
Conclusion: This study has generated reliable data on long-term outcome of live liver donor using national data base. Keeping in mind that donor deaths occur, more attention should be paid in hepatic resection for live liver donor.