Korean J Transplant.  2022 Nov;36(Supple 1):S308. 10.4285/ATW2022.F-4485.

Pure laparoscopic donor right hepatectomy in donor with severe portal vein anomaly

• Han J
• Han YS
• Kim JD
• Choi DL

• KMID: 2535535
• DOI: http://doi.org/10.4285/ATW2022.F-4485

Abstract

Background
Donor operation in adult-to-adult living donor liver transplantation is still associated with postoperative morbidity. But, laparoscopic donor hepatectomy is sporadically reported in a few center with substantial experience and pure laparoscop-ic donor right hepatectomy (PLDRH) has been gradually increased because of cosmetic satisfaction and rapid recovery, despite the controversial issues. We present the case of PLDRH in donor with severe portal vein anomaly to discuss the feasibility of PLDRH.
Methods
A 57-year-old man volunteered to living liver donation for his wife who suffered from hepatic encephalopathy related with cirrhosis. Donors portal vein was unusual type on preoperative computed tomography; Nakamura type - single non-bifurcating portal vein variation. Right hepatic artery and hepatic duct were single. P6 and P7 portal veins were meticulously dis-sected and encircled with vessel loops before liver parenchymal transection, and right anterior portal vein was identified after right hepatic duct transection. Three portal veins were reconstructed to one orifice during bench work procedure.
Results
Donors and recipients portal vein were patent, postoperatively. In postoperative computed tomography on postoperative day 7, there were no abnormal finding both donor and recipient. In postoperative laboratory test including aspartate trans- aminase, alanine transaminase, total bilirubin and international normalized ratio, donor and recipients results were gradually decreased. Donor discharged at postoperative day 8, recipient discharged at postoperative day 23.
Conclusions
PLDRH seems to be a feasible procedure when performed by a highly experienced surgeon, but careful preoperative evaluation and preparations are essential. Laparoscopic donor hepatectomy is being tried consistently and PLDRH can be cautiously expanded to donors with anatomical variation.