Randomized control trial on peri-operative antibiotic prophylaxis in live liver donors - Are three doses enough?

Abstract

Donor safety is paramount in live donor liver transplantation (LDLT)1 . Live donor hepatectomy is a major surgery with an overall morbidity of 20% and major complications rate of about 4-5%1 . Infective complications are the most common morbidity in live liver donors2-4 . Hepatectomy being a clean contaminated surgery along with impaired glucose tolerance, long operating time and major blood loss, leads to recommended use of prophylactic peri-operative antibiotic for decreasing peri-operative surgical site infections and other infective complications5-6 . Overuse of antibiotics, not just increases the cost, but also decreases the patient s innate immunity and gives rise to antibiotic resistance. Optimal duration of prophylactic antibiotic in live liver donor hepatectomy is unclear7-8 . There are few randomized control trials on antibiotic prophylaxis in patients undergoing hepatectomy for other causes with contradictory results9-12 (table 4) but none in live liver donors (LLD). Current study is a single center double blind randomized control equivalence trial comparing efficacy of shorter duration (3 doses) of peri-operative antibiotics versus 9 doses in preventing infective complications after live liver donor hepatectomy.