Korean J Transplant.  2022 Nov;36(Supple 1):S375. 10.4285/ATW2022.F-5152.

Comparison of pure laparoscopic donor right posterior sectionectomy versus right hemihepatectomy: a preliminary study based on surgical outcomes of donors and recipients

• Cho CW
• Choi GS
• Lee DH
• Kim HJ
• Lee DS
• Rhu J
• Kim JM
• Joh JW
• Kim KS

• KMID: 2535229
• DOI: http://doi.org/10.4285/ATW2022.F-5152

Abstract

Background
Right posterior section (RPS) graft for living donor liver transplantation (LDLT) is an alternative graft in a live liver donor with insufficient remnant left lobe (LL) volume and portal vein anomaly. Although there have been some reports regarding pure laparoscopic donor right posterior sectionectomy (PLDRPS), there is no comparative study of PLDRPS versus pure laparo-scopic donor right hemihepatectomy (PLDRH). The aim of our study is to compare surgical outcomes of PLDRPS vs. PLDRH at centers achieving complete transition from open to laparoscopic approach in liver donor surgery.
Methods
From March 2019 to March 2022, a total of 351 LDLTs, 16 and 335 donors underwent PLDRPS and PLDRH, respectively. We reviewed the selection process for RPS grafts and evaluated postoperative outcomes of donors and recipients.
Results
There was no open conversion or perioperative blood transfusion in donors. In the donor cohort, there was no significantly different major complication (grade III) rate and comprehensive complication index (CCI) between PLDRPS versus PLDRH group (6.3% vs. 4.8%, P=0.556 and 2.1±8.4 vs. 1.7±6.4, P=0.788). Furthermore, in the recipient cohort, there was signifi-cantly different major complication (grade III) rate (62.5% vs. 35.2%, P=0.034), but no significantly different CCI (18.3±14.9 vs. 15.2±24.9, P=0.623) between PLDRPS vs. PLDRH group.
Conclusions
PLDRPS in liver donors with portal vein anomaly and insufficient LL was technically feasible and safe with experienced surgeons. PLDRPS group might be comparable with PLDRH group based on surgical outcomes of donors and recipients. However, in terms of recipient outcomes, more careful selection of donor of the RPS graft and further researches in a large num-ber of cases are necessary to evaluate the usefulness of PLDRPS.