Liver Donor Death/Mortality

Living Liver DonorsLiver Donor Risks & Complications

According to the articles regarding Ryan Arnold’s death in 2010, his is only the fourth living liver donor death in the U.S. The other two would be Danny Boone and Mike Hurewitz (the final being Paul Hawkes). However, evidence exists to contradict those claims.

– Surman in 2002 states: At present, there have been seven reported deaths among donors in the United States who have participated in all types (left and right lobe) of partial-liver donation. (112)

– A 2006 analysis of adult-to-adult live liver donor literature lists Boone and Hurewitz, but also a liver donor that committed suicide AND 3 others that died ‘well after surgery’ (113) from a drug overdose, a suicide, and a pedestrian-train accident (141).

– A review of all published articles from the medical literature on living donor liver transplantation and search of the lay literature for donor deaths from 1989 to February 2006 revealed 19 donor deaths (and one additional donor in a chronic vegetative state). Thirteen deaths and the vegetative donor were “definitely,” 2 were “possibly,” and 4 were “unlikely” related to donor surgery. (120) [US and Europe – published 2006]

– A Wall Street Journal article in 2007 states that more than a dozen liver donors have died worldwide after donation from complications resulting from the surgery. (55)

From the 13th Annual International Liver Association Conference in 2007:

“Exact data on morbidity and mortality are not known,” said Burkhardt Ringe, MD, of the Center for Liver, Biliary and Pancreas Disease at Drexel University College of Medicine in Philadelphia, Pennsylvania. Despite 4 independent reviews published in 2006, there are no accurate data on the number of donor deaths. Dr. Ringe also reported that there has in fact been a donor death at his center that is not reflected in the latest reports. (114)

Ringe co-authored an article published in 2008, which attempted to verify 33 reported living liver donor deaths world-wide. Only 36% were directly reported and published by the transplant center where the death occurred. He then criticized the industry for their obfuscation:

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)

From 2009:

It has been estimated that early and delayed death from transplant-related causes can be expected of approximately one in every 200–500 right lobe donors, with permanent disability of a significant number of others.(141) 

OPTN requires all living donor deaths to be reported within 72 hours of the transplant center obtaining knowledge of said death (Section 12.8.4). However, OPTN does not make that information available to the public. And as indicated from above, transplant centers have not always abided by the requirement.

The incidence of death among right-lobe donors is probably 1 percent or more (112).

From 2013 (emphasis mine):

Living donor liver transplantation (LDLT) is associated with a low but finite and well documented risk of donor morbidity and mortality, therefore organizations and individuals involved in this activity must accept the fact that donor death is as a question of “when, not if”. (237)

Last Updated: November 24, 2014