Olivier Soubrane1, Susumu Eguchi2, Shinji Uemoto3, Choon Hyuck David Kwon4, Go Wakabayashi5, Ho-Seong Han6, Ki-Hun Kim7, Roberto Ivan Troisi8,9, Daniel Cherqui10, Fernando Rotellar11, François Cauchy1, Akihiko Soyama2, Satoshi Ogiso3, Gyu-Seong Choi12, Takeshi Takahara13, Jai Young Cho6, Hwui-Dong Cho7, Aude Vanlander8, Gabriella Pittau10, Olivier Scatton14, Fernando Pardo11, Talia Baker15. 1. Department of HPB Surgery and Liver Transplant, Beaujon Hospital, Assistance Publique - Hôpitaux de Paris and University of Paris, France. 2. Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. 3. Department of HBP Surgery & Transplantation, Kyoto University, Graduate School of Medicine, Kyoto, Japan. 4. Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, OH. 5. Center for Advanced Treatment of HBP Diseases, Ageo Central General Hospital, Tokyo, Japan. 6. Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. 7. Division of Hepatobiliary surgery and Liver transplantation, Department of Surgery, Ulsan University and Asan Medical Center, Seoul, Republic of Korea. 8. Department of Human Structure and Repair, Ghent University Faculty of Medicine, Belgium. 9. Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy. 10. Centre Hépato-Biliaire, Paul Brousse Hospital, Villejuif, Assistance Publique - Hôpitaux de Paris, and Paris Saclay University, France. 11. Department of General Surgery, Clínica Universidad de Navarra, School of Medicine, University of Navarra, Pamplona, Spain. 12. Department of General Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea. 13. Department of Surgery, Iwate Medical University School of Medicine, Morioka, Iwate, Japan. 14. Department of Surgery and Liver Transplant, Pitié Hospital, Assistance Publique - Hôpitaux de Paris and Sorbonne University of Paris, France. 15. Department of Surgery, Section of Transplant Surgery, University of Chicago, Chicago, IL.
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.
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.
Authors: Eddy P Lincango Naranjo; Estefany Garces-Delgado; Timo Siepmann; Lutz Mirow; Paola Solis-Pazmino; Harold Alexander-Leon; Gabriela Restrepo-Rodas; Rafael Mancero-Montalvo; Cristina J Ponce; Ramiro Cadena-Semanate; Ronnal Vargas-Cordova; Glenda Herrera-Cevallos; Sebastian Vallejo; Carolina Liu-Sanchez; Larry J Prokop; Ioannis A Ziogas; Michail G Vailas; Alfredo D Guerron; Brendan C Visser; Oscar J Ponce; Andrew S Barbas; Dimitrios Moris Journal: J Clin Med Date: 2022-05-05 Impact factor: 4.964
Authors: Thomas G Cotter; Mohamad Minhem; Jennifer Wang; Thoetchai Peeraphatdit; Fares Ayoub; Anjana Pillai; Roberto Hernandez-Alejandro; Diego di Sabato; Michael Charlton Journal: Liver Transpl Date: 2021-06-24 Impact factor: 6.112