Korean J Transplant.  2022 Nov;36(Supple 1):S354. 10.4285/ATW2022.F-4979.

Laparoscopic donor hepatectomy in settings of pediatric living donor liver transplantation: single center experience

• Monakhov A
• Semash K
• Boldyrev M
• Mescheryakov S
• Gautier S

• KMID: 2535581
• DOI: http://doi.org/10.4285/ATW2022.F-4979

Abstract

Background
The mini-invasive (MIS) approach to living donor hepatectomy is a current trend in experienced centers. At the same time, there are only a few reports describing the utility of laparoscopic donor hepatectomy (LDH) in settings of pediatric living donor liver transplantation (LDLT). We aimed to provide our own experience as a path to implementing the approach to rou-tine practice.
Methods
LDH was used in 276 cases of pediatric LDLT between May 2016 and August 2022. Laparoscopic left lateral sectionectomy (LapLLS) was performed in 240 cases, including 3 cases of simultaneous LapLLS and nephrectomy in the same donor. Laparoscopic living donor left hepatectomy (LapLDLH) was applied in 25 cases, including 2 cases of simultaneous LapLDLH and nephrectomy in the same donor. Laparoscopic right hepatectomy in a living donor (LapLDRH) was performed in 11 cases for LDLT in adolescent recipients.
Results
In the LapLLS group, the blood loss was 50 mL (20–400 mL), the median operation time was 203 minutes (120–475 minutes) and the median length of the hospital stay was 5 days (2–19 days). The LapLDLH and LapLDRH groups were characterized by higher median blood loss 320 mL (100–700 mL) and 240 mL (100–400 mL) respectively; and also a longer operative time of 322 minutes (210–415 minutes), 380 minutes (280–470 minutes). The complication rate was similar to open procedure in both donors and recipients.
Conclusions
The left-sided graft procurement (LLS and LL) is a more demanded procedure in settings of pediatric LDLT. The laparoscopic approach for living donors demonstrates all the advantages of MIS, with preserving recipient outcomes.