{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T17:18:39Z","timestamp":1771607919729,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T00:00:00Z","timestamp":1670544000000},"content-version":"vor","delay-in-days":69,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>While preoperative physiologic evaluation of live liver donors is routinely performed to ensure donor safety and minimize complications, the optimal approach to this evaluation is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We aim to identify predonation physiologic evaluation strategies to improve postoperative short\u2010term outcomes, enhance donor's recovery, and reduce length of stay. We also aim to provide multidisciplinary expert panel recommendations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data sources<\/jats:title><jats:p>Ovid MEDLINE, Embase, Scopus, Google Scholar, and Cochrane Central.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The systematic review followed PRISMA guidelines, and the recommendations were formulated using GRADE approach and experts' opinion. The search included retrospective or prospective studies, describing outcomes of physiologic evaluation predonation. The outcomes of interest were length of stay, postoperative complications (POC), recovery after donation, and mortality. PROSERO protocol ID CRD42021260662.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 1386 articles screened, only three retrospective cohort studies met eligibility criteria. Two studies demonstrated no impact of age (&lt;\u00a070 years) on POC. Increased body mass index's (BMI) association with POC was present in one study (23.8\u00a0vs 21.7\u00a0kg\/m<jats:sup>2<\/jats:sup>, OR 1.67 (1.14\u20102.48), <jats:italic>P<\/jats:italic>\u00a0=\u00a0.01) and absent in another (&lt;\u00a030\u00a0vs 30\u201035\u00a0kg\/m<jats:sup>2<\/jats:sup>, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.61). One study demonstrated decreased risk for postdonation subclinical hepatic dysfunction in donors with higher normal platelet count (PLT). None of the studies noted donor death. Given the scarce data on predonation physiologic testing, the expert panel recommended a battery of tests to guide clinical practice and future investigations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Advancing age (60\u201069 years) is not a contraindication for liver donation. There is insufficient evidence for a specific predonation BMI cut\u2010off. Abbreviated predonation physiologic testing is recommended in all candidates. Comprehensive testing is recommended in high\u2010risk candidates while considering the pretest probability in various populations (Quality of evidence; Low to Very Low | Grade of Recommendation; Strong).<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.14680","type":"journal-article","created":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T09:02:11Z","timestamp":1651568531000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Optimizing pre\u2010donation physiologic evaluation for enhanced recovery after living liver donation \u2013 Systematic review and multidisciplinary expert panel recommendations"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6402-5333","authenticated-orcid":false,"given":"Manhal","family":"Izzy","sequence":"first","affiliation":[{"name":"Department of Medicine Vanderbilt University School of Medicine  Nashville USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert S.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Medicine Weill Cornell Medical College  New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susumu","family":"Eguchi","sequence":"additional","affiliation":[{"name":"Department of Surgery Nagasaki University Graduate School of Biomedical Sciences  Nagasaki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shin","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Liver Transplantation and Hepatobiliary Surgery University of Ulsan  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria A.","family":"Matamoros","sequence":"additional","affiliation":[{"name":"Department of Surgery Center CCSS\u2010Hospital M\u00e9xico  San Jose Costa Rica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristiano","family":"Quintini","sequence":"additional","affiliation":[{"name":"Department of Surgery Cleveland Clinic  Cleveland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3279-7881","authenticated-orcid":false,"given":"Akila","family":"Rajakumar","sequence":"additional","affiliation":[{"name":"Department of Liver Anesthesia and Intensive Care Rela Institute  Chennai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitri Aristotle","family":"Raptis","sequence":"additional","affiliation":[{"name":"Clinical Service of HPB Surgery and Liver Transplantation Royal Free Hospital  London UK"},{"name":"Department of Surgery &amp; Interventional Science University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Spiro","sequence":"additional","affiliation":[{"name":"Department of Surgery &amp; Interventional Science University College London  London UK"},{"name":"Department of Anesthesia and Intensive Care Medicine Royal Free Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy L.","family":"Ascher","sequence":"additional","affiliation":[{"name":"Department of Surgery University of California San Francisco  San Francisco USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the ERAS4OLT.org Working Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,12,9]]},"reference":[{"key":"e_1_2_16_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.30161"},{"key":"e_1_2_16_3_1","unstructured":"Database. UNoOS.https:\/\/unos.org\/data\/Accessed 11\/26 2021."},{"key":"e_1_2_16_4_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v13.i32.4379"},{"key":"e_1_2_16_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.24651"},{"key":"e_1_2_16_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.23575"},{"key":"e_1_2_16_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.tp.0000216825.56841.cd"},{"key":"e_1_2_16_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.1996.tb00881.x"},{"key":"e_1_2_16_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000003246"},{"key":"e_1_2_16_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2535"},{"key":"e_1_2_16_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.04.026"},{"key":"e_1_2_16_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/ebmed-2017-110668"},{"key":"e_1_2_16_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2012.03.013"},{"key":"e_1_2_16_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2013.02.003"},{"key":"e_1_2_16_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.25181"},{"key":"e_1_2_16_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14019"},{"key":"e_1_2_16_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2010.10.001"},{"key":"e_1_2_16_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2019.06.014"},{"key":"e_1_2_16_19_1","doi-asserted-by":"publisher","DOI":"10.4235\/agmr.21.0080"},{"key":"e_1_2_16_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-017-0986-2"},{"key":"e_1_2_16_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.1688"},{"issue":"3","key":"e_1_2_16_22_1","first-page":"370","article-title":"How to define obesity? Evidence\u2010based multiple action points for public awareness, screening, and treatment: an extension of Asian\u2010Pacific recommendations","volume":"17","author":"Pan WH","year":"2008","journal-title":"Asia Pac J Clin Nutr"},{"key":"e_1_2_16_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2005.01124.x"},{"key":"e_1_2_16_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2017.01.023"},{"key":"e_1_2_16_25_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2032183"},{"key":"e_1_2_16_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-020-01024-8"},{"key":"e_1_2_16_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2010.04.029"},{"key":"e_1_2_16_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f5298"},{"key":"e_1_2_16_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.06.059"},{"key":"e_1_2_16_30_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0209347"},{"key":"e_1_2_16_31_1","unstructured":"National Guideline Centre (UK) In:Preoperative Tests (Update): Routine Preoperative Tests for Elective Surgery. London: National Institute for Health and Care Excellence (NICE);2016.https:\/\/pubmed.ncbi.nlm.nih.gov\/27077168\/"},{"key":"e_1_2_16_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2020.100396"},{"key":"e_1_2_16_33_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202002-133VP"},{"key":"e_1_2_16_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacasi.2021.04.007"},{"key":"e_1_2_16_35_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu282"},{"key":"e_1_2_16_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-013-2390-3"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.14680","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ctr.14680","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.14680","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T23:58:31Z","timestamp":1692575911000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.14680"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10]]},"references-count":35,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2022,10]]}},"alternative-id":["10.1111\/ctr.14680"],"URL":"https:\/\/doi.org\/10.1111\/ctr.14680","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10]]},"assertion":[{"value":"2022-01-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14680"}}