Korean J Transplant.  2022 Nov;36(Supple 1):S41. 10.4285/ATW2022.F-1526.

Morbidity of laparoscopic living liver donors and its risk factor during the 10-year period

Affiliations
  • 1Department of Surgery, Samsung Medical Center, Seoul, Korea

Abstract

Background
Although laparoscopic living donor program has been safely established in leading centers, donor morbidity is still remaining. This study reviewed the detailed morbidity of laparoscopic living donors and analyzed the risk factors.
Methods
Laparoscopic living donors operated during May 2013 to June 2022 were reviewed. The detailed information of donors complication was reviewed. Risk factors related to bile leakage and biliary stricture were analyzed using multivariable logistic re-gression method.
Results
During the study period, a total of 636 donors underwent laparoscopic living donor hepatectomy. Open conversion rate was 1.6%. Right liver graft comprised 92.1% (n=586) of cases. Grade IIIa and IIIb complication occurred in 4.4% (n=28) and 1.9% (n=12), respectively. The most common postoperative complication was bleeding (n=38, 6.0%). Fourteen donors (2.2%) required reoperation. Portal vein stricture, bile leakage and biliary stricture occurred in 0.6% (n=4), 3.3% (n=21), and 1.6% (n=10) of cases and every donor returned to their normal life after proper intervention. There was one case of inferior vena cava stricture and thrombosis which was resolved after balloon angioplasty with thromectomy. Risk factors related to bile leakage were hepatic artery variation (odds ratio [OR], 3.067; confidence interval [CI], 1.203–7.818; P=0.019), Free margin <5 mm from main duct (OR, 2.731; CI, 1.099–6.787; P=0.031) and estimated blood loss during operation (OR, 1.002; CI, 1.001–1.003; P=0.004) while Pringle maneuver (OR, 0.311; CI, 0.118–0.920; P=0.018) was protective for leakage. Regarding biliary stricture, only bile leakage was sig-nificant (OR, 11.902; CI, 2.773–51.083; P=0.001) in the multivariable analysis.
Conclusions
Laparoscopic living donor program during the decade showed excellent safety for majority of the donors and critical complications were resolved with proper management.

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