Backgrounds/aims: Challenges arise when translating pure laparoscopic donor right hepatectomy (PLDRH) results from Asian to Western donors, due to differences in body mass index (BMI). This study compares the outcomes of PLDRH and conventional open donor right hepatectomy (CDRH) in donors with BMI over 30.
Methods: Medical records of live liver donors (BMI > 30) undergoing right hepatectomy (2010-2021) were compared: 25 PLDRH cases vs. 19 CDRH cases. Donor and recipient demographics, operative details, and outcomes were analyzed.
Results: PLDRH and CDRH had similar donor and recipient characteristics. PLDRH had longer liver removal and warm ischemic times, but a shorter post-liver removal duration than CDRH. Donor complication rates were comparable, with the highest complication being grade IIIa in PLDRH, necessitating needle aspiration for biloma on postoperative day 11. Fortunately, this donor fully recovered without additional treatment. No complications exceeding Clavien-Dindo grade IIIa occurred in either group. Recipient outcomes between the groups were similar.
Conclusions: This study supports PLDRH as a viable option for donors with BMI over 30, challenging the notion that high BMI should deter considering PLDRH. The findings provide valuable insights into the safety and feasibility of PLDRH, encouraging further exploration of this technique in diverse donor populations.
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http://dx.doi.org/10.14701/ahbps.24-020 | DOI Listing |
Ann Surg Oncol
December 2024
Abdominal Surgery and Transplantation Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Background: The Resection and Partial Liver Transplantation with Delayed Total Hepatectomy (RAPID) procedure for unresectable colorectal liver metastases (uCRLM) has renewed interest by increasing, in selected cases, patients' long-term survival. Initially described using deceased donor graft, this technique evolved to living donors, tackling organ-shortage issues, allowing better scheduling, and reducing liver failure risk.
Methods: A 50-year-old patient presented 18 months earlier with a colic adenocarcinoma with synchronous uCRLM.
Front Oncol
December 2024
Department of Organ Transplantation, the First Affiliated Hospital of Guangxi Medical University, Nanning, China.
surgery and autotransplantation may provide a promising option for radical resection of conventionally unresectable liver tumors. Two cirrhotic patients with hepatocellular carcinoma (HCC), which has an "awkward seat" located in the "intrahepatic vascular triangle area (IVTA)" that consists of the middle hepatic vein (MHV), the right branches of the Glisson sheath, and the inferior vena cava (IVC), underwent extended right-half hepatectomy followed by tumor resection and partial liver autotransplantation. Innovatively, the outflow of the tumor-free liver was reconstructed using pre-frozen allograft blood vessels from brain-dead donors; the patients recovered well postoperation.
View Article and Find Full Text PDFBest Pract Res Clin Gastroenterol
December 2024
Liver Intensive Care Unit, Centre Hépato-Biliaire, AP-HP, Hôpital Paul-Brousse, Université Paris-Saclay, Inserm research unit 1193, Villejuif, F-94800, France. Electronic address:
ABO-compatible Orthotopic Liver Transplantation (OLT) is the standard treatment for patients with acute liver failure (ALF) who meet the criteria for poor prognosis. Contraindications to liver transplantation may be related to the presence of severe medical or psychiatric comorbidities, or to an unstable clinical state incompatible with transplantation. Early mortality predictive scores and factors have been developed to identify futile transplantations that exacerbate organ shortage.
View Article and Find Full Text PDFHepatobiliary Surg Nutr
December 2024
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Hepatobiliary Surg Nutr
December 2024
Liver Transplant Center, Department of General Surgery, West China Hospital of Sichuan University, Chengdu, China.
Background: Minimally invasive surgeries are increasingly central to modern medicine, particularly in liver transplantation. These techniques, which offer reduced trauma, precise operations, minimal bleeding, and swift recovery, are, however, unevenly adopted across China. Only a limited number of centers routinely perform minimally invasive donor hepatectomies, indicating a significant imbalance in the development and application of these advanced procedures.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!