Monday, February 20, 2012

Reports of Liver Donor's Early Deaths Are Grossly Inaccurate

Another lesson in why it's important not to trust headlines, especially when the content originates from an organization's PR department.


4111 live liver donors in the United States between April 1994 and March 2011 for a mean of 7.6 years;

And herein lies the problem. If an individual donates their liver at age 30 when average life expectancy is 76-ish, the fact they haven't kicked off in 16 years or less proves nothing.

Yet....


Long-term mortality of live liver donors was comparable to that of live kidney donors and NHANES participants.

Unless the definition has changed, 7 years or even 11 years is NOT long-term. That only applies to anything over 20 or so years.

But here's a nice paragraph:


In general, our understanding of catastrophic complications arising from live liver donation has been partly informed by the media, case reports, and center-specific studies. Although a multicenter consortium, an analysis of health care registry data, and a nationwide survey have attempted to address the shortcomings in the literature, these efforts have been limited by selection and ascertainment biases, small sample size, and the lack of a generalizable denominator for accurate risk estimation.


But then there's this:

...the risks associated with live donor nephrectomy are well characterized

I'm sorry - WTF?? We don't have so much as social security numbers on the first 40 yrs of living kidney donors, we've only required one to two years of follow-up on the last 10, and of those, 30% are reported 'lost'. So we have no data.

Let me repeat that - WE HAVE NO DATA.


I encourage you to read the entire study, available here. Just understand the authors include both right and left lobe donors, when the two procedures have been shown to have vastly different risk levels (see our pages on live liver donors for more). Most of all, be suspicious if you run across any news articles that purport the safety of live liver donation. This article does nothing of the sort, despite the wishes of its authors.





Muzaale, A., Dagher, N., Montgomery, R., Taranto, S., Mcbride, M., & Segev, D. (2012). Estimates of Early Death, Acute Liver Failure, and Long-term Mortality Among Live Liver Donors Gastroenterology, 142 (2), 273-280 DOI: 10.1053/j.gastro.2011.11.015