Ann Liver Transplant.  2023 May;3(1):11-16. 10.52604/alt.23.0010.

Outcomes of pure laparoscopic donor hepatectomy for a right lobe graft weighing more than 1,000 g

• Hong SK
• Kim M
• Kim Y
• Kim J
• Choi HH
• Lee J
• Kim J
• Hong Sy
• Lee JM
• Choi Y
• Yi NJ
• Lee KW
• Suh KS

• KMID: 2560916
• DOI: http://doi.org/10.52604/alt.23.0010

Abstract

Background
Minimally invasive hepatectomy has gained popularity in donor hepatectomy for living-donor liver transplantation. Guidelines suggest that pure laparoscopic donor hepatectomy should be considered a standard practice for experienced surgical teams. Pure laparoscopic donor right hepatectomy (PLDRH) is performed in selected cases. High graft weight has been reported to be an important factor in the selection process. This study aimed to determine whether it is safe and feasible to use PLDRH on large liver grafts weighing >1,000 g by analyzing multiple cases.
Methods
We retrospectively reviewed the medical records of PLDRH cases in which the graft weight exceeded 1,000 g between November 2015 and December 2021.
Results
Twenty cases of PLDRH were identified in which the graft weight exceeded 1,000 g. The median operative time, time to liver removal, and estimated blood loss were 322.5 minutes, 229.0 minutes, and 325.0 mL, respectively. There was a slight trend towards a decreased total operative time as the number of cases increased. The warm ischemic time significantly decreased as the number of cases increased. The median duration of hospital stay for donors was 7.0 days, and only two cases each of grade I and grade II complications were reported. No complications rated as grade III or higher were observed.
Conclusion
PLDRH on large liver grafts weighing over 1,000 g is feasible and safe for experienced surgical teams, as it shows good postoperative outcomes with no major complications.

Keyword

Donor hepatectomy; Laparoscopy; Living donor liver transplantation; Right hepatectomy; Graft size

Figure

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  Figure 1 Correlation between (A) operative time and (B) warm ischemic time with the progressive performance of pure laparoscopic donor right hepatectomy in grafts weighing over 1,000 g.

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