SUNY Upstate Medical University, New York Syracuse, New York
Abdul Wahab Dogar, MBBS, FCPS1, Azhar Hussain, MD2, Kaleem Ullah, MBBS, FCPS1, Shams Ud-Din, MBBS, FCPS1, Kalsoom Khalil, MBBS3, Abu Hurairah, MD4, Muhammad Furqan, MBBS5, Madho Mal, MBBS6, Abdul Ghaffar, MBBS, FCPS1 1Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Sindh, Pakistan; 2SUNY Upstate Medical University, New York, Syracuse, NY; 3Ameer Ud Din Medical College, Lahore, Punjab, Pakistan; 4AdventHealth, Orlando, FL; 5King Edward Medical University, Lahore, Punjab, Pakistan; 6Liaquat University of Medical and Health Science, Jamshoroo, Sindh, Pakistan
Introduction: Glucose-6 Phosphate Dehydrogenase (G6PD) is the most common enzyme deficiency disorder which can cause a spectrum of post-operative complications among live liver donors.
Methods: This cross-sectional study studied the prevalence and severity of G6PD deficiency among 152 live liver donors. We also evaluated the pre-and post-operative outcomes among 14 G6PD deficient donors with the 35 non-deficient donors who underwent right lobe hepatectomy. All patients were followed to check the hemolysis and other post-hepatectomy complications for 1 year.
Results: 14/152 (0.92%) live liver donors were G6PD deficient. Among 14 donors, four (28.57%) were WHO class-II G6PD deficient, while ten (71.42%) had WHO class-III G6PD deficient. None of the donors had WHO class-I G6PD deficiency. Pre-operative hemoglobin was comparable among G6PD deficient donors and non-deficient donors (13.18 ± 2.16 vs 13.20 ± 1.43, p=0.9), while post-operative hemoglobin was lower deficient donors compared to non-deficient donors (9.98 ± 1.58 vs 11.30 ± 0.82, p=0.021). Hemolysis was detected in three (21.14%). Moreover, total serum bilirubin was significantly elevated among G6PD deficient donors compared to non-deficient donors (3.89±2.67 vs 2.21±1.46, p=0.027), and the same trend was observed in serum indirect bilirubin. No blood transfusion was required.
Discussion: G6PD deficiency has a low incidence in Europe and America but has a high prevalence in the Mediterranean, Arabic, and Asian populations, especially the South Asian population where LDLT is commonly practiced. One school of thought is that G6PD deficiency adds risk to the donors, and it's better to avoid them. However, a substantial proportion of the liver donor’s pool gets rejected due to the non-availability of other suitable donors. With increasing experience and shortage of donors, most LDLT centers move to a more accommodating approach. This study of 14 class II &III G6PD deficient donors is the first big series of LLDs who underwent right hepatectomy. We observed the drop in post-operative hemoglobin level secondary to surgical stress-related hemolysis, which was biochemically evident in only a few cases. The G6PD deficiency is an X-link genetic disorder that affects mostly males. In our study, the majority of deficient donors were male [10(66.67%].
Glucose-6 phosphate deficient donors undergoing right lobe hepatectomy should be screened for G6PD deficiency quantitatively as it poses a risk of hemolysis in deficient donors, especially female donors.
Disclosures:
Abdul Wahab Dogar indicated no relevant financial relationships.
Azhar Hussain indicated no relevant financial relationships.
Kaleem Ullah indicated no relevant financial relationships.
Shams Ud-Din indicated no relevant financial relationships.
Kalsoom Khalil indicated no relevant financial relationships.
Abu Hurairah indicated no relevant financial relationships.
Muhammad Furqan indicated no relevant financial relationships.
Madho Mal indicated no relevant financial relationships.
Abdul Ghaffar indicated no relevant financial relationships.
Abdul Wahab Dogar, MBBS, FCPS1, Azhar Hussain, MD2, Kaleem Ullah, MBBS, FCPS1, Shams Ud-Din, MBBS, FCPS1, Kalsoom Khalil, MBBS3, Abu Hurairah, MD4, Muhammad Furqan, MBBS5, Madho Mal, MBBS6, Abdul Ghaffar, MBBS, FCPS1. P3843 - Severity and Impact of Glucose-6 Phosphate Dehydrogenase Deficiency in Living Right Lobe Liver Donors Undergoing Right Lobe Hepatectomy, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.