Minimally Invasive Donor Hepatectomy for Adult Living Donor Liver Transplantation An International, Multi-institutional Evaluation of Safety, Efficacy and Early Outcomes

Olivier Soubrane, Susumu Eguchi, Shinji Uemoto, Choon Hyuck David Kwon, Go Wakabayashi, Ho Seong Han, Ki Hun Kim, Roberto Ivan Troisi, Daniel Cherqui, Fernando Rotellar, Francois Cauchy, Akihiko Soyama, Satoshi Ogiso, Gyu Seong Choi, Takeshi Takahara, Jai Young Cho, Hwui Dong Cho, Aude Vanlander, Gabriella Pittau, Olivier ScattonFernando Pardo, Talia Baker

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)

Abstract

Objective: Evaluating the perioperative outcomes of minimally invasive (MIV) donor hepatectomy for adult live donor liver transplants in a large multi-institutional series from both Eastern and Western centers. Background: Laparoscopic liver resection has become standard practice for minor resections in selected patients in whom it provides reduced postoperative morbidity and faster rehabilitation. Laparoscopic approaches in living donor hepatectomy for transplantation, however, remain controversial because of safety concerns. Following the recommendation of the Jury of the Morioka consensus conference to address this, a retrospective study was designed to assess the early postoperative outcomes after laparoscopic donor hepatectomy. The collective experience of 10 mature transplant teams from Eastern and Western countries was reviewed. Methods: All centers provided data from prospectively maintained databases. Only left and right hepatectomies performed using a MIV technique were included in this study. Primary outcome was the occurrence of complications using the Clavien-Dindo graded classification and the Comprehensive Complication Index during the first 3 months. Logistic regression analysis was used to identify risk factors for complications. Results: In all, 412 MIV donor hepatectomies were recorded including 164 left and 248 right hepatectomies. Surgical technique was either pure laparoscopy in 175 cases or hybrid approach in 237. Conversion into standard laparotomy was necessary in 17 donors (4.1%). None of the donors died. Also, 108 experienced 121 complications including 9.4% of severe (Clavien-Dindo 3-4) complications. Median Comprehensive Complication Index was 5.2. Conclusions: This study shows favorable early postoperative outcomes in more than 400 MIV donor hepatectomy from 10 experienced centers. These results are comparable to those of benchmarking series of open standard donor hepatectomy.

Original languageEnglish
Pages (from-to)166-174
Number of pages9
JournalAnnals of Surgery
Volume275
Issue number1
DOIs
Publication statusPublished - 01-01-2022
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery

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