Objective: Evaluating the perioperative outcomes of minimally invasive (MIV) donor hepatectomy for adult live donor liver transplants in a large multi-institutional series from both Eastern and Western centers.
Background: Laparoscopic liver resection has become standard practice for minor resections in selected patients in whom it provides reduced postoperative morbidity and faster rehabilitation. Laparoscopic approaches in living donor hepatectomy for transplantation, however, remain controversial because of safety concerns. Following the recommendation of the Jury of the Morioka consensus conference to address this, a retrospective study was designed to assess the early postoperative outcomes after laparoscopic donor hepatectomy. The collective experience of 10 mature transplant teams from Eastern and Western countries was reviewed.
Methods: All centers provided data from prospectively maintained databases. Only left and right hepatectomies performed using a MIV technique were included in this study. Primary outcome was the occurrence of complications using the Clavien-Dindo graded classification and the Comprehensive Complication Index during the first 3 months. Logistic regression analysis was used to identify risk factors for complications.
Results: In all, 412 MIV donor hepatectomies were recorded including 164 left and 248 right hepatectomies. Surgical technique was either pure laparoscopy in 175 cases or hybrid approach in 237. Conversion into standard laparotomy was necessary in 17 donors (4.1%). None of the donors died. Also, 108 experienced 121 complications including 9.4% of severe (Clavien-Dindo 3-4) complications. Median Comprehensive Complication Index was 5.2.
Conclusions: This study shows favorable early postoperative outcomes in more than 400 MIV donor hepatectomy from 10 experienced centers. These results are comparable to those of benchmarking series of open standard donor hepatectomy.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/SLA.0000000000003852 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Evaluation of Liver Volume Estimation Methods in Living Donor Liver Transplant: CT Volumetry vs MeVis, With Comparison of Open and Laparoscopic Surgery.
Transplant Proc
January 2025
Department of Hepatopancreatobiliary & Transplant Surgery, Singapore General Hospital, Singapore; SingHealth Duke-NUS Transplant Centre, Singapore; Duke-NUS Medical School, Singapore.
Background: Accurately assessing graft volume is crucial for donor and recipient safety in living donor liver transplantation. This can be performed using manual computed tomography volumetry (CTvol) or semiautomated methods (MeVis). We aimed to compare CTvol and MeVis in estimating the actual graft weight during LDLT, and analyse any differences in weight between laparoscopic and open donor hepatectomy.
View Article and Find Full Text PDFExploring auxiliary liver transplantation in the era of transplant oncology - A proposal for a new liver splitting program (ALERT-50).
Liver Transpl
January 2025
Hepato-biliary-pancreatic Surgery and Liver Transplantation Unit, Padua University Hospital, Padua, Italy.
Total hepatectomy and liver transplantation has emerged as a game-changing strategy in the treatment of several liver-confined primary or metastatic tumors, opening the new era of transplant oncology. However, the expansion of indications is going to worsen the chronic scarcity of organs, and new strategies are needed to enlarge the donor pool. A possible source of organs could be developing split liver transplantation (SLT) programs.
View Article and Find Full Text PDFIntroduction We aimed to assess whether partial hepatectomy has an influence on conventional and speckle tracking parameters on echocardiography in living liver donors in the early postoperative period. Methods This study was a retrospective study to investigate the cardiac effects of liver donation after the transplant operation in a high-volume liver transplant center. Ninety living liver donors were included in the study.
View Article and Find Full Text PDFFeasibility of Pure Laparoscopic Donor Right Hepatectomy Compared to Open Donor Right Hepatectomy: A Large Single-Center Cohort Study.
Ann Surg
January 2025
Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Objective: This study aimed to compare morbidity of living donors and recipients after pure laparoscopic donor right hepatectomy (PLDRH) and open donor right hepatectomy (ODRH).
Background: Donor and recipient morbidity have not been sufficiently reported in large-scale comparisons of PLDRH and ODRH.
Methods: This retrospective study reviewed 3348 donors who underwent PLDRH (n=329) and ODRH (n=3019) and their corresponding recipients (n=3348) between January 2014 and August 2023.
Early outcomes of robotic vs open living donor right hepatectomy in a US Center.
Surg Endosc
January 2025
Division of Transplant Surgery, Department of Surgery, Hume- Lee Transplant Center, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
Background: Robotic living donor hepatectomy offers potential advantages but has been limited to high-volume centers, primarily in Asia and the Middle East. We report our experience establishing a robotic living donor right hepatectomy program in a U.S.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!