Diaphragmatic Hernia After Living Donor Right Hepatectomy

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Record number: 
Adverse Occurrence type: 
MPHO Type: 
Estimated frequency: 
Reported incidences in the literature range from 0.6% to 2.3%. The most common risk factor was right lobe donation and potentially conditions resulting in increased intra-abdominal pressure, such as preoperative obesity, postoperative weight gain or pregnancy. To date (2016), there have only been 9 reported cases of this rare complication, all of which required operative repair . The authors also present 2 case reports from their own institution (1.6% total diaphragmatic hernia rate, 2.3% right lobe specific rate).
Time to detection: 
> 19 months (19 months - 5 years in the 2 case reports presented).
Alerting signals, symptoms, evidence of occurrence: 
Abdominal pain, nausea, and vomiting.
Demonstration of imputability or root cause: 
Symptoms, abdominal and cest x ray, CT (computed tomography).
Imputability grade: 
3 Definite/Certain/Proven
Groups audience: 
Suggest references: 
Livingstone SM, Andres A et al. Diaphragmatic Hernia After Living Donor Right Hepatectomy: Proposal for a Screening Protocol. Transplant Direct. 2016 Jun 2;2(7):e84. eCollection 2016.
Expert comments for publication: 
The development of a diaphragmatic hernia after living donor hepatectomy is a rare but significant complication that often results in obstruction or strangulation of intestinal contents and should be repaired as soon as identified. The implementation of a screening chest x-ray to follow-up protocols for early identification could lead to repair before the development of complications.