02322nas a2200205   4500008004100000020001400041024001400055245009800069210006900167260002400236300000800260490000600268520168600274100002601960700001701986700002402003700002402027700002002051856004502071       2016                        eng d  a2373-8731  a10165160900aDiaphragmatic Hernia After Living Donor Right Hepatectomy: Proposal for a Screening Protocol.0 aDiaphragmatic Hernia After Living Donor Right Hepatectomy Propos  aUnited Statesc2016  ae840 v23 aBACKGROUND: Living donor hepatectomy (LDH) is increasingly being used to improve access to liver transplantation for those with end-stage liver disease. Although recipient outcomes are equivalent, donor complication rates range from 10% to 41%. A rare, but potentially serious complication is occurrence of a diaphragmatic hernia (DH), of which 9 cases have been reported so far in the literature. The purpose of this work was to review the clinical impact of DH post-LDH, including risk factors (RF) in hope of mitigating impact., METHODS: A literature review was performed identifying all previous reports of post-operative DH in living liver donors. Demographic and outcome data were gathered to help identify RF. We also report 2 cases from our own institution., RESULTS: Reported incidences range from 0.6% to 2.3%, of which the majority are delayed (>19 months). Obstruction or intestinal strangulation was present in 45%, 60% of whom required an intestinal resection. The most common RF was right lobe donation., CONCLUSIONS: Postoperative DH is a rare but serious complication of LDH. The major RFs are right lobe donation and potentially conditions resulting in increased intraabdominal pressure. Diaphragmatic hernia frequently lead to intestinal obstruction and strangulation and should be repaired when identified. The implementation of a screening protocol for early identification could lead to repair before the development of complications. We propose the addition of screening chest x-ray to follow-up protocols to aid in the identification and subsequent repair of postoperative DH. Such a practice could hopefully reduce the clinical impact of this complication.1 aLivingstone, Scott, M1 aAndres, Axel1 aShapiro, A, M James1 aKneteman, Norman, N1 aBigam, David, L  uhttp://613633.bywedr.asia/reference/4580