Case Reports *Associate Professor of Anesthesiology †Assistant Professor of Anesthesiology ‡Scientist, Department of Anesthesiology §Assistant Professor of Surgery  Professor of Surgery Address correspondence to Dr. Beebe at the Department of Anesthesiology, University of Minnesota Medical School, Box 294, B515 Mayo, 420 Delaware St. SE, Minneapolis, MN 55455, USA. E-mail: beebe001@tc.umn.edu Received for publication August 12, 1999; revised manuscript accepted for publication December 21, 1999. Living Liver Donor Surgery: Report of Initial Anesthesia Experience David S. Beebe, MD,* Richard Carr, MD,† Vijaya Komanduri, MS,‡ Abhi Humar, MD,§ Rainier Gruessner, MD, PhD,  Kumar G. Belani, MBBS MS  Department of Anesthesiology and Department of Surgery, University of Minnesota Medical School, Minneapolis, MN The charts and anesthetic records of 12 patients who donated the left lateral segment of their liver to a related infant or child to treat liver failure were retrospectively reviewed. Blood loss, need for transfusion, fluids administered, surgical length, and perioperative complications were investigated. The records also were examined to determine the hemodynamic stability of patients undergoing donor hepatectomy to assess their need for invasive monitoring. There were no episodes of hypotension or hemodynamic instability. The average operating time was 9.6  1.1 hours. The blood loss was 562  244 mL (range 300 to 1100 mL). Four patients received their own cell saver blood (200 mL, 220 mL, 300 mL, 475 mL), and one patient received 1 U (350 mL) of predonated autologous blood. The average hemoglobin decreased significantly (p = 0.001) from a preoperative value of 14.1  1.2 to 12.3  1.8 g/dL in the recovery room. All patients were extubated in the operating room or recovery room. Patients were discharged home in 6.9  1.3 days (range 5 to 9 days). Living-related liver resection can be performed with noninvasive monitoring and without the need for heterologous blood products. © 2000 by Elsevier Science Inc. Keywords: Anesthesia, complications; Liver transplantation; Living-related liver donors. Introduction The number of patients needing liver transplantation exceeds the number of cadaveric donors available. Up to 25% of pediatric patients listed by the United Network for Organ Sharing will die within 1 year while waiting for an organ. Living-related liver transplantation is one partial solution to this shortage. 1 The first attempted transplant of a living-related liver segment was performed by Raia et al. 2 in 1989. This recipient died, but a successful transplant of the left lobe of a mother’s liver into her child was performed by Strong et al. 3 in 1989. Since then, transplantation from living-related donors have been performed in many centers worldwide, with 1-year graft and patient survival rates of 85% or greater. 1 Living-related liver transplantation exposes the donor to the risks of hepa- Journal of Clinical Anesthesia 12:157–161, 2000 © 2000 Elsevier Science Inc. All rights reserved. 0952-8180/00/$–see front matter 655 Avenue of the Americas, New York, NY 10010 PII S0952-8180(00)00114-8