Korean J Transplant.  2022 Nov;36(Supple 1):S107. 10.4285/ATW2022.F-2268.

Safety of pure laparoscopic donor hepatectomy for adult living donor liver transplant: comparison with laparoscopic non-donor hepatectomy

• Linn YL
• Chong Y
• Wang Z
• Tan EK
• Koh YX
• Chan CY
• Jeyaraj PR
• Goh BK

• KMID: 2535623
• DOI: http://doi.org/10.4285/ATW2022.F-2268

Abstract

Background
Pure laparoscopic donor hepatectomy (L-DH) has seen a rise in uptake in recent years following the popularization of minimally invasive modality for major hepatobiliary surgery, but has not yet become standard of care due to the relatively small sample sizes in existing studies and small number of centers performing the procedure. Our study aimed to assess the safety of L-DH compared to laparoscopic non-donor hepatectomy (L-NDH) in our center.
Methods
We used propensity score matching to compare perioperative outcomes of L-DH against a cohort of L-NDH in a 2:1 ra-tio. Eighty laparoscopic hemi-hepatectomies performed between 2015 and 2022 were included, of which 11 were L-DH. Patients were matched for body mass index, gender, ASA status, and laterality.
Results
The L-NDH cohort were significantly older (P<0.05) with higher ASA scores (P<0.05) compared to the L-DH cohort. While the L-NDH patients had a shorter median operative time compared to the L-DH (P<0.05), they had a longer median length of stay (P<0.05). No patient who underwent L-DH experienced postoperative complication (Clavien-Dindo 3). None of the patients who underwent L-DH required reoperation nor readmission within 30-days, and none of them experienced postoperative liver decom-pensation or bile leak. There were no open conversions. There was no significant difference in complication rate between the L-DH and L-NDH cohort after 2:1 matching.
Conclusions
L-DH is a safe procedure with similar outcomes compared to L-NDH, and may be attempted by surgeons who are experienced in performing L-NDH and open donor hepatectomies.