Clinical utility of postoperative phosphate recovery profiles to predict liver insufficiency after living donor hepatectomy

Oscar Serrano, Steven J Mongin, Danielle Berglund, Varshita Goduguchinta, Apoorva Reddy, David M Vock, Varvara Kirchner, Raja Kandaswamy, Timothy L Pruett, Srinath Chinnakotla

Research output: Contribution to journalArticle


Background: Living donor hepatectomy (LDH) is associated with significant postoperative hypophosphatemia. Methods: From January 1997 through July 2017, we performed 176 LDH and compared donors who developed liver insufficiency (LI) to those that did not within 30 days of LDH. Using smoothing splines, we constructed a mixed-effects model and assessed receiver operating characteristic curves. Results: Of the 176 donors, 161 were included in our study and 10 (6.2%) developed LI. The cohorts differed in minimum observed phosphate levels (1.77 mg/dL, LI cohort; 2.01 mg/dL No LI cohort) at a median nadir of 1.6 days (38 h) postoperatively (p = 0.003). In the ROC analysis, intraoperative time and postoperative phosphate levels best predicted LI (sensitivity, 90%; specificity, 55.6%). Conclusion: Mean postoperative phosphate profiles differ significantly between those patients who develop LI and those who do not in the first 38 h after LDH.

Original languageEnglish (US)
Pages (from-to)374-379
Number of pages6
JournalAmerican journal of surgery
Issue number2
StatePublished - Aug 2019



  • Hypophosphatemia
  • Liver insufficiency
  • Living donor hepatectomy

PubMed: MeSH publication types

  • Journal Article

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