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Objectives At our center living donor liver transplantation (LDLT) represents 4% of all transplantations. The aim of this cross-sectional study was to clarify the current well-being of the donors, their experiences of being a donor, as well as the regenerative capacity of the liver. Patients and Method Thirty-six healthy subjects donated a part of their liver between 1996 and 2007. Thirty-four patients participated in the study and completed our questionnaire. We performed magnetic resonance imaging (MRI) of the liver, physical examination, and blood chemistry. Results Twenty-three subjects had donated the left lateral segment and 11 the right lobe. Their hospital stay ranged from 5–15 days (median, 10). Mostly, the sick-leave period was 8–12 weeks and time for recovery was 3–6 months. Long-term problems were heartburn, abdominal discomfort, incisional hernia, and fatigue. Twenty-six (76.5%) subjects viewed the donation experience as entirely positive; no one was regretful. Liver function tests were normal. The MRI data at follow-up of 13 left lateral segment and 11 right lobe grafts showed recovery of the total liver volume to almost preoperative values, mean 1522 ± 241 mL versus 1552 ± 219 mL, respectively. Conclusion Living liver donors commonly recovered after 3–6 months, perceiving donation as a positive experience with no regret. Durable side effects were mainly heartburn and abdominal discomfort, but the symptoms were mostly mild. Liver function was normal. The MRI data showed a mean regeneration of liver volume to 98.6% of the preoperative values.

Prior research on donor monoclonal gammopathy of undetermined significance (MGUS) has been inadequate regarding the risk for lymphoproliferative disease in solid organ transplantation recipients. Seven organ recipients from two different donors developed lymphoproliferative disease. The origin of the malignancy was determined by use of microsatellite analysis, and the plasma of the two donors was analyzed with the use of electrophoresis. The clinical courses of the seven recipients were followed for 36-60 months. One donor transmitted lymphoplasmacytic lymphoma to two kidney recipients and MGUS to a liver recipient, all IgMκ. A second donor caused IgGλ myeloma in two kidney and one liver recipient, and IgGλ gammopathy in a heart recipient. Transplant nephrectomy was performed in three kidney recipients and remission was achieved. The fourth kidney recipient has kept the graft and the disease has progressed. The liver recipient died from myeloma. There were no clinical signs of lymphoproliferative disease in the donors, but retrospective serum analyses showed M-components, IgMκ (37 g/L) and IgGλ (8 g/L). Donors with MGUS may cause donor-transmitted malignancies via passenger lymphocytes/plasma cells in solid organ recipients. The results call for a large register study of the incidence of donor MGUS and lymphoproliferative disease in their recipients.

Serum vitamin A concentrations were measured in 22 patients with laryngeal cancer and found to be significantly lower than those of patients of similar age with either nonmalignant laryngeal or other than laryngeal diseases. The levels of vitamin A in the patients with laryngeal cancer, but not in the controls, significantly correlated with serum concentrations of retinol-binding protein (RBP) and zinc. It is suggested that low levels of zinc might reduce the synthesis of RBP and thus reduce the mobilization of vitamin A from the liver stores.