Objective: Aim of this study was to present the experience of 3000 consecutive donor hepatectomies performed in single centre.

Background: Donor liver resection is a major and complex surgical operation performed in healthy, living liver donors for the benefit of liver recipients. We share our experience and outcomes of 3000 donor hepatectomy surgeries over 15 years in evaluating the donor, surgical techniques and post-operative management

Methods: Three thousand donor hepatectomies performed between 2005 and 2019 were included in the study. First 1500 cases were considered as era 1 and later 1500 cases were labeled as era 2. Both the eras were compared in terms of standard practices and donor outcomes

Results: The rejection rate for donation decreased from 44.3% in era 1 to 16.5% in era 2. Mean operative time, mean blood loss and blood transfusion rate reduced from 412± 122 min, 395± 188 ml and 11% to 346± 116 min, 324± 151 ml and 5.3% respectively in era 1 and era 2. Clavien Dindo grade 3 complications reduced from 9.6% in era 1 to 3.5% in era 2. (p=0.01) Two donors have died during follow up but there were no surgical related mortalities in both the eras.

Conclusion: Careful donor selection and surgical techniques can minimize complications and overcome the shortage of cadaveric donation in India.