BACKGROUND/AIMS: The liver hanging maneuver (LHM) is a widely used novel suspending technique for facilitating liver transection. However, little evidence is available to reveal its safety and true advantages in donor operations for living donor liver transplantation (LDLT). METHODOLOGY: The medical records of 422 consecutive living donors at a single institute were reviewed. The feasibility and outcomes of the use of LHM in donor operation for LDLT were investigated. RESULTS: Two types of hanging maneuvers, namely, Belghiti's conventional method and a modified approach where the sling is placed after full mobilization of the liver, have been routinely adopted selectively since 2000, and to date, 304 LHM have been carried out. Marked reduction in the liver transection time needed for harvesting a hemiliver graft has been obtained after the introduction of LHM (p<0.0001). No major complications associated with the LHM have been recorded. Comparison of the conventional and modified LHM revealed similar outcomes for the two, except that the modified approach required a longer liver dissection time (81 vs. 98 min; p=0.0004). CONCLUSIONS: Considering its high feasibility and several advantages in facilitating liver transection, LHM might be worth attempting in donor operations where a major hepatectomy is required.
BACKGROUND/AIMS: The liver hanging maneuver (LHM) is a widely used novel suspending technique for facilitating liver transection. However, little evidence is available to reveal its safety and true advantages in donor operations for living donor liver transplantation (LDLT). METHODOLOGY: The medical records of 422 consecutive living donors at a single institute were reviewed. The feasibility and outcomes of the use of LHM in donor operation for LDLT were investigated. RESULTS: Two types of hanging maneuvers, namely, Belghiti's conventional method and a modified approach where the sling is placed after full mobilization of the liver, have been routinely adopted selectively since 2000, and to date, 304 LHM have been carried out. Marked reduction in the liver transection time needed for harvesting a hemiliver graft has been obtained after the introduction of LHM (p<0.0001). No major complications associated with the LHM have been recorded. Comparison of the conventional and modified LHM revealed similar outcomes for the two, except that the modified approach required a longer liver dissection time (81 vs. 98 min; p=0.0004). CONCLUSIONS: Considering its high feasibility and several advantages in facilitating liver transection, LHM might be worth attempting in donor operations where a major hepatectomy is required.